Radiation-induced angiosarcoma of the breast: A case report

Introduction and importance: Today, breast-conserving surgery (BCS) and adjuvant radiotherapy are preferred treatments for patients with early invasive breast cancer. Radiation-induced angiosarcoma (RIAS) of the breast is a rare but serious complication of radiotherapy. Case presentation: Seventy-one-year-old woman is presented to our department with a locally advanced dark red polypoid lesion on her left breast. She had left BCS, axillary dissection, and adjuvant radiotherapy for invasive breast cancer 8 years before presentation. A small tissue sample from the breast lesions was sent for histopathologic examination that the diagnosis was angiosarcoma of the breast. She had neoadjuvant chemotherapy. Following the completion of chemotherapy, a total mastectomy was performed as surgical treatment. The final histopathologic diagnosis was well-differentiated angiosarcoma. Clinical discussion: RIAS of the breast is rare disease that develops after a several-year latency period. Locally advanced disease was initially treated with neoadjuvant chemotherapy which appears to be effective for significant disease regression. Patients who respond well to chemotherapy in vivo may have higher disease-specific survival rates. After chemotherapy-induced regression of locally advanced sarcoma, total mastectomy was performed for radical treatment. Conclusion: RIAS of the breast is defined as the histological diagnosis of angiosarcoma in an irradiated region after a long latency period in a patient who has previously received radiotherapy for breast carcinoma. Based on clinical and nuclear imaging data, we may conclude that neoadjuvant chemotherapy can result in significant disease regression, and following neoadjuvant chemotherapy the treatment of angiosarcoma is completed by radical breast surgery.