Multiple primary atypical vascular lesions occurring in the same breast

Atypical vascular lesions (AVLs) of the breast are rare cutaneous vascular proliferations that appear as flesh-colored or erythematous papules or macules in women who have undergone radiation treatment for breast carcinoma. These lesions can develop in the irradiated area up to 20 years after the radiation treatment but most commonly occur within 3 to 6 years. The general consensus agrees on the benign nature of AVLs; however, their identity as benign lesions has been a source of controversy over the years, with some investigators proposing that AVLs may be a precursor lesion to postirradiation angiosarcomas. Currently, there are no specific guidelines to direct clinicians on the effective treatment of AVLs, but most AVLs are treated with total excision. This rare case describes the development of 4 AVLs within the same breast and stresses the relevance of the field effect in AVL development as well as the importance of field monitoring.