A Case of Radiation-induced Breast Angiosarcoma that Developed following Breast-conserving Surgery

Todoroki, Hidekazu; Shimada, Kaoru; Tsutsumi, Nobuo; Koga, Tomohiro

doi:10.3919/jjsa.75.2125

Cited by 4 publications

(2 citation statements)

References 18 publications

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“…Angiosarcoma is an uncommon, malignant, blood vessel tumor. Angiosarcoma of the breast comprises 0.05% of all malignant tumors of the breast [2]. Cohen-Hallaleh et al…”

Section: Discussionmentioning

confidence: 99%

“…In addition, postoperative radiotherapy has been performed in many cases with positive axillary node metastasis. Moreover, the number of patients who receive RT is estimated to increase in the future [2]. However, due to difficulties in the diagnosis of angiosarcoma with fine needle aspiration (FNA) or core needle biopsy (CNB), misdiagnosis is frequently reported, delaying the radical surgery [3,4].…”

Section: Introductionmentioning

confidence: 99%

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Recurring radiation-induced angiosarcoma of the breast that was treated with paclitaxel chemotherapy: a case report

et al. 2020

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Background: Angiosarcoma of the breast is very rare and can be divided into primary and secondary angiosarcoma. Radiation-induced angiosarcoma (RIAS) is classified as secondary angiosarcoma. Diagnosis of RIAS is difficult due to its rarity, and the interpretation of pathological imaging is complicated. In the National Comprehensive Care Network (NCCN) guidelines, the first choice of treatment is surgery with negative margins. Adjuvant radiotherapy (RT) for close soft tissue margins should be considered. Preoperative or adjuvant chemotherapy of nonmetastatic disease is not recommended for angiosarcoma. We report a case of RIAS, which was impossible to diagnose with core needle biopsy (CNB) but was diagnosed by excisional biopsy. The patient was then administered adjuvant chemotherapy using conjugated paclitaxel (PTX). Case presentation: A 62-year-old woman noticed a tumor in her right breast. She had a history of right breast cancer and had undergone breast-conserving surgery, RT, and tamoxifen therapy 8 years previously. CNB, which was performed twice, was inconclusive. The tumor was surgically excised and pathological analysis yielded a diagnosis of angiosarcoma. She then underwent a right mastectomy. One month after she underwent right mastectomy, a nodule reappeared on the skin of her right breast, and excisional biopsy revealed recurrence of angiosarcoma. A few weeks later another nodule reappeared near the post-operative scar and excisional biopsy revealed recurrence of angiosarcoma. We assumed that surgical therapy was insufficient because the patient experienced relapse of angiosarcoma after complete mastectomy. After the second recurrence, we treated her with systemic chemotherapy using PTX. There was no evidence of recurrence 8 months after chemotherapy. Conclusion: Although angiosarcoma is difficult to diagnose, many patients have a poor prognosis. Therefore, prompt treatment intervention is desired. Moreover, there is little evidence regarding adjuvant therapy of angiosarcoma since it is a rare disease. We consider that adjuvant therapy helped to effectively prevent recurrence in the patient after complete excision.

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“…Angiosarcoma is an uncommon, malignant, blood vessel tumor. Angiosarcoma of the breast comprises 0.05% of all malignant tumors of the breast [2]. Cohen-Hallaleh et al…”

Section: Discussionmentioning

confidence: 99%