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Radiation-Induced Angiosarcoma of the Breast With Diffuse GATA-3 Positivity: A Possible Diagnostic Pitfall
Vicki Mercado-Evans1,2, Kaitlyn Levett2, Abdul Hafeez Diwan2,3
1Medical Scientist Training Program, Baylor College of Medicine, Houston, TX; and.
The American Journal of Dermatopathology
|March 13, 2026
Summary
Radiation-induced breast angiosarcoma, a rare cancer, can present with unexpected GATA-3 positivity. This finding challenges typical diagnostic markers and is crucial for accurate diagnosis in post-radiation patients.
Area of Science:
- Oncology
- Pathology
- Medical Imaging
Background:
- Radiation-induced angiosarcomas of the breast are rare and have a poor prognosis.
- Typical immunohistochemical markers include CD31 and ERG positivity, indicating vascular differentiation.
- GATA-3 is a marker for breast carcinoma but not typically associated with angiosarcomas.
Purpose of the Study:
- To report a case of radiation-induced breast angiosarcoma with unusual GATA-3 positivity.
- To highlight a potential diagnostic pitfall in identifying breast angiosarcomas.
Main Methods:
- Case report of an 83-year-old woman with a history of breast cancer treated with radiation.
- Histopathological examination and immunohistochemical analysis of the breast tumor.
- Evaluation of markers including GATA-3, CD31, ERG, CD34, MYC, and Ki-67.
Main Results:
- The tumor was diagnosed as radiation-induced angiosarcoma.
- The tumor showed diffuse positivity for GATA-3, CD31, and ERG, with focal CD34 positivity.
- MYC was strongly positive, and the Ki-67 index was increased. Other markers were negative.
Conclusions:
- This case demonstrates diffuse GATA-3 positivity in radiation-induced breast angiosarcoma, a previously unreported finding.
- Awareness of this GATA-3 staining pattern is critical for accurate diagnosis, especially when distinguishing from recurrent breast carcinoma.
