Introduction: Breast angiosarcoma is a very rare and highly aggressive lesion, with an incidence of 0.5% to 1%. Berg et al. recognized two groups of sarcoma: the first group includes malignant phylloid cysts, lymphomas, and hemangiosarcomas, and the second group includes stromal sarcomas, fibrosarcomas, leiomyosarcomas, histiocytomas, and giant cell sarcoma. Angiosarcomas are lesions of indefinite and friable masses, with a mean age of 35 years. Case Report: A 35-year-old man from Paulo Afonso-PE presents complaining of breast lump. He underwent tumorectomy and confirmed fibroadenoma and phylloids with atypia and mitosis. A battery of tests such as mammography (MMG)/ultrasonography (USG) confirmed the presence of a 1.5-cm nodule in the breast. In addition, a new segmental resection surgery was performed, in which histopathological results confirmed a low-grade malignant phylloid cystosarcoma and demanding margins. The patient was proposed a new surgical of simple mastectomy with immediate reconstruction with silicone implant and latissimus dorsi flap. Finally, the surgery was performed and the histopathological result was the absence of residual neoplastic tissue, with an area of scar fibrosis and typical ductal hyperplasia. After recovery, the patient was referred to clinical oncology and radiotherapy, but both had no indication for adjuvant therapy. After 1 year, the patient returned to perform the symmetry of the opposite breast and reconstruction of the nipple–areola complex. In her follow-up, there were no changes in her examinations. After 2 years, she returned with a breast USG examination, which demonstrated an image nodular 1.5 cm adjacent to breast prosthesis and magnetic resonance imaging suggested the same image. A core was performed, confirming a recurrent malignant variant tumor. The tumor evolved very quickly, and the surgery was performed with an enlarged resection of the entire large and small pectoral and inclusion of the skin. For correction of the deformity, the rotation of the large epiploid with a lower abdominal dermocutaneous flap was used. Conclusion: The use of a technique with the large epiploid to cover the chest wall associated with a lower abdominal dermocutaneous flap presented a good alternative to correct chest wall deformity.

Introduction: Breast cancer is the most recurring type of cancer among women, with reduced mortality at an initial stage of lesion. From a radiological perspective, perceived microcalcifications may be associated with histological findings such as proliferative injuries with or without atypical features and ductal carcinoma in situ. Currently, percutaneous and vacuum biopsies allow for the correlation between anatomoradiological and identification of previous lesions and those that offer the risk of cancer. No biomarker has been established to predict the risk of cancer in women diagnosed with benign mammary disease. Doing so could strengthen the possibility of stratifying the individual risk of benign injuries for cancer. The platelet-derived growth factor receptor A (PDGFRA) plays its part in tumor oncogenesis, angiogenesis, and metastasis, and its activation is found in some kinds of cancer. In contrast, DNA methylation standards are initial changes to the development of cancer and may be helpful in its early identification, being regulated by a family of enzymes called DNMTs (DNA methyltransferase). Methods: The aim of this study was to evaluate the profile of BI-RADS® 4 and 5 mammary microcalcification women carriers and determine the level of the gene expression of possible molecular markers in 37 patients with mammary microcalcification (paraffin blocks) and 26 patients with breast cancer (fresh in RNA later tissue) cared for at the Hospital Barão de Lucena’s Mastology Ambulatory. Anatomoradiological aspects along with clinical findings have been evaluated , and percentage rates have been calculated. The PDGFRA and DNMTs (DMNT3a) gene expressions have been established using quantitative polymerase chain reaction (qPCR), with the use of β-actin as reference gene. Discussion: In the patients with mammary microcalcification, the average age was 55.9; predominantly whiteskinned subjects (p<0.014). Most of them were mothers (p<0.001), and the average menarche age was 13. The subgroups that presented greater significance were patients classified BI-RADS® in category IV (67.6%) and histological findings of nonproliferative lesion (p<0.001). Lesions of the ductal carcinoma in situ type (100%) presented positive estrogen and progesterone receptors, and 94.6% have undergone sectorectomy surgery by prior needling (p<0.001). The most damaged breast was the left one (62.2%), and the most affected quadrant was the top lateral one (59.5%) (p<0.001). There was no family history in 83.8% of the cases. In the tested microcalcification samples, it was not possible to observe the expression of PDGFRA. Nevertheless, 15 out of 37 patients with microcalcification showed an increase in the gene expression of DMNT3a, most of them greater than Luminal and triple-negative cancer types. Conclusion: The data presented here highlight the improvement on the description of BI-RADS® 4 subclassification in order to better conduct the clinical decision and also demonstrated the potential of DNMTs evaluation in microcalcification samples as a strategy to access the understanding about the role of these molecules in the breast cancer development.

Introduction: Breast angiosarcoma is very rare and highly aggressive. It has an incidence of 0.5% to 1% of cases and its presentation is typically in women between 14 and 82 years of age with an average age that revolves around 35 years. Breast angiosarcoma presents clinically as a unilateral, softened tumor with ill-defined borders and skin thickening, with a variable growth rate. However, if compared to epithelial breast cancer, angiosarcoma has a faster growth rate. The second is known as stromal sarcoma, fibrosarcoma, leiomyosarcoma, histiocytoma, and giant cell sarcoma. Regarding adjuvant therapy, chemotherapy and radiotherapy, they present an ineffective response. The effective treatment to offer a chance of healing is a broad surgical approach. Case report: Female patient U..S., 35, from Paulo Afonso, state of Pernambuco, complaining of a left breast nodule. She had a tumorectomy in her city, due to fibroadenoma and phyloid tumors with atypia and mitosis. In our service, she underwent a series of tests, where mammogram/ultrasonography confirmed the presence of a 1.5 cm nodule in the left breast.She underwent a new segmental resection surgery, whose histopathology confirmed a low-grade malignant cystosarcoma phyllodes and exiguous margins.A new surgical proposal was discussed with the patient – a simple mastectomy with immediate reconstruction with silicone breast implant and latissimus dorsi flap. The surgery was performed and the histopathological result was the absence of residual neoplastic tissue, with an area of scar fibrosis and usual ductal hyperplasia. After her recovery, the patient was referred to clinical oncology and radiotherapy, but both had no indication for adjuvant therapy. After one year, the patient returned to undergo symmetrization of the opposite breast and reconstruction of the nipple-areolar complex. After two years, the patient returned with a breast US, which demonstrated a nodular image of 1.5 cm adjacent to the breast prosthesis and an MRI suggested the same image. A core biopsy was performed, which confirmed a malignant variant recurrent tumor. The tumor evolved very quickly and the surgery was performed with an enlarged resection of the entire pectoralis large and small and skin inclusion. To correct the deformity, we used the rotation of the great epiploon with the lower abdominal dermocutaneous flap.