Primary Angiosarcoma of the Breast: A Case Report and Review of Literature

Angiosarcoma of the breast (ASB) is a rare but aggressive tumor with very poor prognosis. It is important to recognize this tumor early and to distinguish between primary and secondary ASB. While mammograms frequently miss these lesions, ultrasound and MRI show promise as imaging modalities. In spite of characteristic features described on pathology, misdiagnosis is common, with over 35% tumors initially thought to be benign. We present the case of a 32-year-old woman with a history of bilateral reduction mammoplasty who presented with a non-tender lump in her right breast. After repeated aspirations and biopsies, a diagnosis of primary ASB was made. She underwent bilateral simple mastectomies followed by adjuvant chemo-therapy and radiation. While surgery is the mainstay of treatment, roles of radiation and chemo-therapy are still evolving; we review the literature and discuss the decision pathways for diagnosis and management of this rare tumor.