Low-grade angiosarcoma of the skin of the breast: a complication of lumpectomy and radiation therapy for breast carcinoma.
A case of low-grade angiosarcoma arising in the skin of a breast previously irradiated for breast carcinoma is reported. Initially, an asymptomatic breast mass was detected. Excisional biopsy and axillary lymph node dissection revealed a 1.5-cm infiltrating ductal carcinoma with 21 negative lymph nodes. The neoplasm was staged as T1, N0, M0. The patient was entered in a research protocol and was treated with high-dose external beam (4,860 rad) and iridium implant (1,860 rad) irradiation. Seven years later the patient developed low-grade angiosarcoma of the breast skin. The lesion recurred following excision and eventually was treated by simple mastectomy. The patient never had evidence of lymphedema. Cutaneous angiosarcomas occurring as a complication of lumpectomy and radiation therapy for breast carcinoma are rare. In some reported cases the patients have had lymphedema, a known factor predisposing to angiosarcoma. Furthermore, almost all cases previously reported have been high grade. This case suggests that radiation therapy for breast carcinoma may also be complicated by low-grade angiosarcoma.
Moskaluk
C A
CA
Laboratory of Pathology, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892.
Merino
M J
MJ
Danforth
D N
DN
Medeiros
L J
LJ
D001940:Breast; D001943:Breast Neoplasms / Q000532:radiotherapy / Q000601:surgery; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000532:radiotherapy / Q000601:surgery; D005260:Female; D006394:Hemangiosarcoma / Q000473:pathology*; D006801:Humans; D015412:Mastectomy, Segmental / Q000009:adverse effects; D008875:Middle Aged; D009381:Neoplasms, Radiation-Induced / Q000473:pathology*; D016609:Neoplasms, Second Primary / Q000473:pathology*; D011878:Radiotherapy / Q000009:adverse effects; D012878:Skin Neoplasms / Q000473:pathology*