Key result
A female patient with primary breast angiosarcoma initially misdiagnosed as a benign hemangioma was treated with mastectomy and radiation, later developing contralateral disease and metastases.
Case Report (n=1)
Primary breast angiosarcoma is difficult to diagnose on core biopsy, and highly vascular breast masses should be considered malignant until proven otherwise.
May warrant considering malignancy in highly vascular breast masses; leaves open need for prospective diagnostic validation.
Background. Primary breast angiosarcoma is a rare entity. Case. Initial diagnosis was a benign hemangioma at core biopsy. Wide local excision was performed, with positive margins. Pathology after surgery reported a moderately differentiated angiosarcoma. Tumor was finally treated using mastectomy and radiations. She developed a second angiosarcoma in contralateral breast, with an initial diagnosis on core biopsy of an atypical vascular lesion and was again treated using mastectomy and radiations. She developed bones and lung metastases. Conclusion. Primary breast angiosarcoma is a rare entity often difficult to diagnose on core biopsy, and a benign differential diagnosis is frequent. A highly vascular breast mass should always be considered malignant until proven otherwise. Surgical treatment seems to be the best course of action. There is a lack of data proving efficacy of adjuvant chemotherapy and radiation therapy.
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Desbiens et al. (2011) conducted a case report in Primary breast angiosarcoma (n=1). Mastectomy and radiation was evaluated. A female patient with primary breast angiosarcoma initially misdiagnosed as a benign hemangioma was treated with mastectomy and radiation, later developing contralateral disease and metastases.
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