Multidisciplinary approach to breast angiosarcoma in an elderly patient: Repeated local relapses and significant objective responses

Abstract

Angiosarcomas are malignant tumors of endovascular origin, which may be divided into primary and secondary forms. Secondary breast angiosarcomas are an increasing problem, especially in patients treated with breast-conserving surgery followed by radiotherapy.We report a case of radiation-induced angiosarcoma of the breast in a 77-year-old woman who presented with a suspect lesion in her left breast. Excisional biopsy and subsequent immunohistochemical staining of the specimen was performed. Histological report was diagnostic for low-intermediate grade angiosarcoma. The tumor cells were diffusely positive for CD31 and CD34. We performed surgical resection with mastectomy.A multidisciplinary approach with bleomycin-based electrochemotherapy, radiation treatment, and chemotherapy with pegylated liposomal doxorubicin has been most useful to control subsequent local relapses. To date, the patient is under close observation and is performing well. No recurrence has been demonstrated after ending of chemotherapy.

Breast Primary Angiosarcoma: A Clinicopathologic and Imaging Study of a Series Cases

“… 8 , 21 A new therapy may be offered by trials of biological treatments using anti-growth factor antibodies, in particular anti-vascular endothelial growth factor (VEGF) and anti-fibroblast growth factor (FGF). 21 , 22 …”

Preoperative radiation in large angiomatosis of the breast, attempting breast conserving surgery: multidisciplinary approach

“…While radiation in angiosarcoma is controversial. Hyperfractionated radiotherapy was reported an encouraging outcome [ 9 ]. However, external beam radiotherapy is scarcely performed in benign vascular tumour.…”

Salvage Hypofractionated Radiotherapy in a Progressive Radiation-Induced Angiosarcoma: A Case Report

“…Furthermore, CD34 and Factor VIII are expressed in most angiosarcomas but less in poorly differentiated tumors [ 8 ]. Currently, taxanes and anthracyclines are considered the most effective therapies for aggressive angiosarcomas [ 9 ]; however, novel targeted therapies are being studied [ 10 ]. Despite the intrinsic radioresistance of angiosarcomas, radiotherapy is widely suggested both with curative and palliative intents in advanced disease [ 1 ].…”