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Post‐radiotherapy vascular lesions of the breast: immunohistochemical and molecular features of 74 cases with long‐term follow‐up and literature review
- Source :
- Histopathology. 77:293-302
- Publication Year :
- 2020
- Publisher :
- Wiley, 2020.
-
Abstract
- Aims A wide range of post-radiotherapy (RT) vascular lesions can occur, ranging from benign lymphangiomatous papules of the skin (BLAPs), to atypical vascular lesions (AVLs) and post-RT angiosarcomas (ASs). The relationship between benign and malignant post-RT breast lesions and their prognostic features are still controversial. The aims of this study were to investigate the relationship between benign and malignant mammary post-RT vascular lesions and to define post-RT AS prognostic features. Methods and results Seventy-four post-RT vascular lesion cases were obtained and stained with antibodies against CD34, CD31, D2-40, Ki67, and c-Myc. Mutational analysis was performed by deep sequencing for the following genes: KRAS, NRAS, HRAS, BRAF, PIK3CA, TP53, NOTCH1, PTEN, CDKN2A, EGFR, AKT1, CTNNB1, hTERT, and PTPRB. Post-RT AS cases were graded according to a previously reported breast AS grading system. AVL cases showed a low number of HRAS and hTERT mutations, whereas post-RT AS cases showed a high frequency of EGFR, TP53, HRAS and hTERT mutations. On follow-up, all BLAP and AVL patients were alive with no evidence of disease. Post-RT AS 5-year overall survival declined with the increase in grade, as follows: 85.7% for grade 1, 83.3% for grade 2, and 40.4% for grade 3. Conclusions Our findings confirm that BLAP and AVL have a good prognosis, and that post-RT AS prognosis is strongly related to histological grading. On molecular analysis, AVL and post-RT AS shared HRAS and hTERT mutations, suggesting a relationship between the two lesions.
- Subjects :
- 0301 basic medicine
CD31
Neuroblastoma RAS viral oncogene homolog
Pathology
Neoplasms, Radiation-Induced
Skin Neoplasms
Vascular Malformations
DNA Mutational Analysis
neoplasms
Gene mutation
haemangiosarcoma
medicine.disease_cause
Gene
0302 clinical medicine
CDKN2A
Breast
genes
Telomerase
biology
General Medicine
Middle Aged
Prognosis
Immunohistochemistry
030220 oncology & carcinogenesis
Atypical Vascular Lesion
Female
KRAS
Adult
medicine.medical_specialty
Histology
Hemangiosarcoma
Breast Neoplasms
Pathology and Forensic Medicine
Proto-Oncogene Proteins p21(ras)
03 medical and health sciences
medicine
Humans
PTEN
HRAS
atypical vascular lesions
Aged
Radiotherapy
business.industry
Oncogenes
medicine.disease
Peptide Fragments
breast
030104 developmental biology
Mutation
biology.protein
Neoplasm Grading
business
Follow-Up Studies
Subjects
Details
- ISSN :
- 13652559 and 03090167
- Volume :
- 77
- Database :
- OpenAIRE
- Journal :
- Histopathology
- Accession number :
- edsair.doi.dedup.....103b47fcd130597e4cc6ed897a6d1ef4