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A Case of Radiation-induced Collision Cancer between Breast Angiosarcoma and Invasive Ductal Carcinoma in a Patient with Li-Fraumeni Syndrome

The patient was a 53-year old woman who had noticed a right breast mass three weeks earlier and presented herself at a clinic for examination. She was diagnosed as having right breast angiosarcoma, breast cancer, cecal cancer and uterine cancer. Eleven years earlier, she had been diagnosed as having right breast cancer and received chemotherapy and radiotherapy without surgery. She gave a family history of juvenile rectal cancer. She was treated by hysterectomy and ileocecal resection, and underwent right mastectomy, axillary dissection and skin grafting a month later. The final pathological diagnosis of the breast tumor was a collision cancer between angiosarcoma and invasive ductal carcinoma. She was diagnosed as having Li-Fraumeni syndrome (LFS) and underwent genetic counselling. She received adjuvant chemotherapy (weekly paclitaxel) for 6 months after the surgeries, but the angiosarcoma showed local recurrence and she received pazopanib therapy. We report a case of radia-tion-induced collision cancer between breast angiosarcoma and invasive ductal carcinoma in a patient with LFS.