Radiation-Induced Angiosarcoma Following Breast Surgery: A Case Report

Radiation-induced angiosarcoma of the breast is a rare but aggressive secondary malignancy that develops several years after breast surgery and adjuvant radiation therapy. Because of its poor prognosis and diagnostic challenges, early recognition and complete surgical excision are essential for optimal management.

We report a 72-year-old woman who presented with multiple painful, dark purple nodules in her left breast 7 years after breast-conserving surgery and adjuvant radiation therapy for adenoid cystic carcinoma. A core needle biopsy confirmed angiosarcoma. A total mastectomy with wide skin excision, including all overlying breast skin, and split-thickness skin grafting from the left thigh was performed to ensure negative margins, which were pathologically confirmed. Surgical removal of the tumor completely relieved her breast pain. She remains recurrence-free 6 months after surgery.

Treatment for radiation-induced angiosarcoma is primarily surgical, with mastectomy and negative margins being the standard approach. Early detection is crucial to achieve complete resection, emphasizing the importance of careful follow-up and close attention to skin changes in patients who have received breast surgery with radiation therapy.