Two cases of breast angiosarcoma after breast conserving surgery

Area of Science:

• Oncology
• Surgical Pathology
• Radiation Oncology

Background:

• Breast angiosarcoma (AS) is a rare vascular endothelial malignancy with a poor prognosis.
• The efficacy of chemotherapy and radiation for AS remains controversial.
• Surgical resection with adequate margins is the primary curative treatment for AS.

Purpose of the Study:

• To report two cases of breast angiosarcoma (AS), one primary and one radiation-induced.
• To highlight the importance of surgical margins in preventing local recurrence of AS.
• To discuss the challenges in preoperative diagnosis and margin assessment for breast AS.

Main Methods:

• Presentation of two distinct cases of breast angiosarcoma.
• Case 1: Radiation-induced AS in a 72-year-old female post-breast-conserving surgery (BCS) and radiation therapy (RT).
• Case 2: Primary AS in an 80-year-old female post-BCS without RT, both treated with mastectomy and wide skin resection.

Main Results:

• Both patients developed local recurrence within one year of surgical intervention.
• Case 1 AS was diagnosed as radiation-induced due to c-myc positivity.
• Case 2 AS was diagnosed as primary due to absence of prior RT or lymphedema.

Conclusions:

• Surgical margin status is significantly associated with the risk of local recurrence in breast AS.
• Preoperative diagnosis and careful assessment of surgical margins are critical for optimal management of breast AS.
• Further research is needed to establish definitive treatment guidelines for breast angiosarcoma.