Postradiation cutaneous vascular tumors of the breast: a review

Postradiation vascular tumors fall into two categories: (1) postradiation cutaneous angiosarcoma, malignant vascular neoplasms with significant morbidity and mortality; and (2) atypical vascular lesions (AVL), vascular tumors that reportedly behave in a benign manner. Postradiation vascular tumors not only present a therapeutic problem for clinicians, but they present an increasingly common diagnostic dilemma for pathologists. Although first described separately 15 years ago, the relationship between postradiation cutaneous angiosarcoma and AVL remains controversial. It appears that, in at least some cases, angiosarcoma can arise in the context of AVL, suggesting that these lesions are part of a spectrum of the same disease process. This latter view point is supported by the significant clinical and histologic overlap found between both tumors. Herein, we will discuss the evolution of this topic while reviewing the various clinical, histopathologic, and prognostic characteristics of postradiation cutaneous angiosarcoma and AVL.