Secondary breast angiosarcoma following accelerated partial breast irradiation with intracavitary multicatheter applicator brachytherapy

PURPOSE: Secondary angiosarcoma of the breast is a rare complication of breast radiotherapy and is associated with a poor prognosis. There are many reported cases of secondary angiosar-coma following whole breast irradiation (WBI), however development of secondary angiosarcoma following brachytherapy-based accelerated partial breast irradiation (APBI) is not as well charac-terized.METHODS AND MATERIALS: We reviewed and reported a case of a patient who developed secondary angiosarcoma of the breast following intracavitary multicatheter applicator brachyther-apy APBI.RESULTS: A 69-year-old female was originally diagnosed with T1N0M0 invasive ductal car-cinoma of the left breast and treated with lumpectomy followed by adjuvant intracavitary mul-ticatheter applicator brachytherapy APBI. Seven years following her treatment, she developed secondary angiosarcoma. However, the diagnosis of secondary angiosarcoma was delayed due nonspecific imaging findings and a negative biopsy.CONCLUSIONS: Our case highlights the need for secondary angiosarcoma to be considered the differential diagnosis when patients present with symptoms such as breast ecchymosis skin thickening following WBI or APBI. Prompt diagnosis and referral to a high-volume sarcoma treatment center for multidisciplinary evaluation is vital.& COPY; 2023 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.