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Case Series
Variable presentations of radiation-associated angiosarcoma in patients treated for breast cancer
1 FCPS, Member of Royal College of Physicians and Surgeons (Glasgow), FEBS, Specialty Doctor, Breast Surgery, Peterborough City Hospital, Peterborough, UK
2 FRCS, MSc, Consultant Oncoplastic Breast Surgeon, Peterborough City Hospital, Peterborough, UK
Address correspondence to:
Samreen Khan
Breast Unit, Peterborough City Hospital, Peterborough,
UK
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Article ID: 100108Z12SK2022
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Khan S, Goh S. Variable presentations of radiation-associated angiosarcoma in patients treated for breast cancer. J Case Rep Images Surg 2022;8(2):21–25.ABSTRACT
Introduction: Radiation-associated angiosarcoma is a rare and late complication of radiotherapy in breast cancer. Its incident is reported in the range of 0.03–0.3%. It carries a poor prognosis with a 5-year survival rate of 43–54%. Due to its non-specific presentation, diagnosis is often delayed.
Case Report Case 1: A 60-year-old female presented six years after her breast cancer treatment with a history of bruising over the breast following trauma. Initial imaging and punch biopsy only showed inflammatory change. Her breast symptoms progressed and repeat biopsy revealed angiosarcoma. She was treated with chemotherapy followed by mastectomy. Case 2: A 60-year-old female treated for breast cancer, presented two and a half years later with subtle erythema over the breast. Imaging was normal. Punch biopsy showed angiosarcoma and she underwent mastectomy. Case 3: A 90-year-old female presented eight years after treatment for breast cancer. Her symptoms included blisters over the breast that bled at times. Punch biopsy showed angiosarcoma. There was rapid disease progression with convergence of the blisters into a large necrotic mass. She underwent a mastectomy for local control. The angiosarcoma recurred a year later and she died within three months of recurrence.
Conclusion: Radiation-associated angiosarcoma is rare but carries a poor prognosis. Due to its non-specific presentation, diagnosis is often delayed. A high level of suspicion is needed in patients presenting with unusual breast symptoms and changes post-treatment.
Keywords: Breast cancer treatment, Breast radiotherapy, Radiation-associated angiosarcoma
SUPPORTING INFORMATION
Author Contributions
Samreen Khan - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Steven Goh - Substantial contributions to conception and design, Revising it critically for important intellectual content, Final approval of the version to be published
Guarantor of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2022 Samreen Khan et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
