Radiation-induced breast angiosarcoma: A case report

ABSTRACT Introduction: Breast angiosarcomas are rare and aggressive conjunctival malignancies. They represent 0.04% of malignant breast tumors and 8–10% of all breast sarcomas. There are two forms; a primary one with no known precursor, and one secondary to breast irradiation. Case report: Patient aged 63 years, mother of four, known hypertensive on treatment, operated 07 years ago by right breast conservative surgery with at pathology report; CMI type NOS, grade II SBR, endoluminal B, (0 N+/10 N). The patient received chemotherapy, radiotherapy and hormone therapy for 5 years. Seven years later, she presented with a mass in the right axillary extension, near the lumpectomy scar, classified as ACR BI-RADS 4 on echomammography. The tru-cut biopsy objectified a radiation-induced breast angiosarcoma on immunohistochemistry. The patient underwent a right mastectomy. Discussion: Breast angiosarcoma is a rare and aggressive conjunctival tumor. There are two forms of angiosarcoma, primary with unknown precursor and secondary occurring after breast irradiation. The mode of revelation is the appearance of breast nodule rapidly increasing in volume. Histological confirmation of the sarcomatous component on the post-radiation lesion allows the diagnosis to be made. Surgery is the only treatment for radiation-induced angiosarcoma. The role of adjuvant therapies remains limited in the treatment of radiation-induced angiosarcoma. Conclusion: Radiation-induced angiosarcoma is a rare malignant tumour occurring in patients who have undergone breast conserving treatment. Its diagnosis is confirmed by histological study and surgery is the cornerstone of treatment. Highlights