Primary and Secondary Breast Angiosarcoma

Abstract

Breast angiosarcoma is a rare and aggressive tumor. The role of 18 F-FDG PET/CT in breast angiosarcoma is poorly known. We report a series of 13 lesions in 11 patients with histologically proven primary or secondary breast angiosarcoma who underwent FDG PET/CT at the initial assessment in our institution. All breast lesions showed FDG avidity. Visually and statistically, we observed a significant difference of SUV max uptake foci between primary and secondary breast angiosarcoma (Wilcoxon test P < 0.0046) and a significantly poorer prognosis for high SUV max than those with low SUV max (P = 0.049) regardless of primary or secondary origins.

Positive FAPI PET/CT in a Bilateral Mammary Angiosarcoma Patient With Less Impressive FDG PET/CT Images

“…High-grade poorly differentiated primary breast angiosarcoma and secondary breast angiosarcoma with intense uptake of FDG have been reported previously. [1][2][3] However, well-differentiated angiosarcoma of the breast could not be well visualized by 18 F-FDG PET/CT due to unremarkable FDG uptake in this case. 68 Ga-FAPI PET/CT has shown diagnostic value in patients with various tumors including sarcomas.…”

Radiation-associated angiosarcoma of the breast with initial presentation as non-mass enhancement on MRI

“…There is mixed evidence regarding the prognostic utility of tumor size and histologic grade [19] . Lastly, lesions demonstrating higher SUV max values on FDG PET/CT have been shown to have a poor prognosis regardless of breast angiosarcoma type [15] .…”

“…There is scarce literature investigating the role of FDG PET/CT in the evaluation of RAASB. In the only published series of patients with breast angiosarcoma who underwent pretreatment FDG PET/CT, Cassou-Mounat et al [15] demonstrated that there was a statistically significant difference in SUV max between primary and secondary types.…”

Asymptomatic Primary Breast Angiosarcoma in 45-Years-Old Woman

“…Primary breast angiosarcoma occurs sporadically with unknown aetiology. The secondary one is radiation-induced angiosarcoma, which arises in the dermal and subcutaneous layers of the skin and the average latency period is 5-6 years [5,6]. The typical patient with primary breast angiosarcoma is a young woman with no previous cancer history with dense breast parenchyma [1,4].…”