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Radiation-Induced Breast Angiosarcoma

Importance: Radiation-induced angiosarcoma after conservative treatment of breast cancer affects a small percentage of patients but has a significant impact on survival. Early detection requires a high index of suspicion and is important for optimal management of this aggressive disease. Observations: The patient reported here presented with radiation-induced angiosarcoma of the left breast 14 years after radiation therapy. Histopathology was positive for anti-CD31, anti-CD34, D2-40, and anti–factor VIII (von Willebrand). She underwent a total mastectomy and is still in remission 20 months later. The authors present a review of the clinical presentation, diagnostic methods, and treatment options. Conclusions: This case report demonstrates the importance of long-term follow-up and investigation of even the subtlest cutaneous changes in the breast after radiation treatment, because radiation-induced angiosarcoma is a very aggressive disease that could benefit from early diagnosis and management.