Angiosarcoma of the Breast Following Lumpectomy and Radiation Therapy for Breast Carcinoma: Case Report and Review of the Literature

Abstract: A case of angiosarcoma of the breast following lumpectomy and radiotherapy is described. A search of the literature found this entity to be first described in 1987. Thirty-two additional cases were found, one of which was bilateral in the same patient. The goal of this paper is to highlight the clinical presentation, diagnosis, and treatment of this problem. Heightened awareness of this condition is critical to those who provide long-term follow-up care for women treated with breast preservation for breast cancer. The average age of diagnosis of the breast carcinoma was 62 years. The average latency interval to the development of angiosarcoma was 69 months, shorter than angiosarcoma following radiotherapy to other anatomic sites. Accepted treatment is simple mastectomy. No correlation between dosage of radiotherapy, site of angiosarcoma development, or use of a boost dose was found. Seventeen patients recurred; not all had adequate follow-up data. Of those that did, there are 7 that survived between 9 and 36 months after first recurrence. Eight died either of or with recurrent angiosarcoma. One of the shortcomings of case report literature is lack of adequate follow-up. Conclusions about prognosis following a diagnosis of angiosarcoma after breast conservation is greatly limited by this. However, aggressive therapy even after recurrence of angiosarcoma appears to be of benefit in at least a subset of patients. Breast cancer treated conservatively is gaining favor, and cases of angiosarcoma of the breast as a complication of it are likely to increase as well. The true incidence and short- and long-term prognosis will remain elusive unless a registry of this complication is established.