Atypical Postradiation Vascular Proliferation: A Rare Dermatologic Sequela of Breast Cancer Therapy

A structured PubMed and Google Scholar literature search through November 2024 identified 193 patients across relevant studies, with emphasis on post-breast cancer radiation cohorts including adjuvant treatment for gynecologic and pediatric malignancies with chest wall involvement. APRVP demonstrates strong female predominance and typically manifests 6-10 years post-radiation as variable morphologic lesions with potential for discharge or secondary changes. Radiation-induced vascular injury and lymphatic dysfunction represent the underlying pathophysiology. Critical diagnostic differentiation from angiosarcoma relies on clinical context, histopathology showing absence of MYC gene amplification, endothelial multilayering, and deep tissue invasion. Complete surgical excision remains the treatment standard for solitary lesions, while multifocal disease may require individualized approaches including staged excision or monitoring. Topical corticosteroids demonstrate efficacy in symptom management for select cases. Although benign, APRVP carries a 16-46% risk of recurrence or further development of new lesions, recommending long-term surveillance. Future research priorities include identifying predictive biomarkers and establishing evidence-based management protocols for this increasingly recognized complication of breast cancer treatment.