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Angiosarcoma of the Breast

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Updated June 11, 2014

Description of Breast Angiosarcoma:

A breast angiosarcoma is a rare type of breast cancer which starts in cells that line the blood vessels within your breast or underarm area. It can occur due to breast and upper arm radiation treatments, and is apt to grow and spread quickly. Breast angiosarcoma may at first appear similar to a skin rash, infection, or bruising.

A Rare Breast Cancer Diagnosis:

A sarcoma is a type of cancer that grows in soft or connective tissue, and an angiosarcoma can occur in any organ of your body. Less than 10% of all angiosarcomas originate in the breast. Angiosarcoma of the breast accounts for about 0.04%, or one in 2,500 cases of all breast cancer diagnoses.

Primary and Secondary Breast Angiosarcoma:

Primary angiosarcoma of the breast is usually diagnosed in young women, between the ages of 20 to 40. These primary cancers show up as an ill-defined mass in the breast. Secondary angiosarcoma is often diagnosed in women over 40, 5 to 10 years after they have had radiation treatment for breast cancer. The American Cancer Society states that angiosarcoma is a very rare complication of breast radiation. Women who developed lymphedema as a result of lymph node removal may also be diagnosed with angiosarcoma, particularly if their underarm area received radiation.

Also Known As:

Angiosarcoma of the breast, mammary angiosarcoma, haemangiosarcoma of the breast, lymphangiosarcoma (if occurs in lymph node area)

Signs and Symptoms of Breast Angiosarcoma:

Primary angiosarcoma (diagnosed in a patient who has never had breast cancer) may feel like a thickened area of the breast. In some cases, the nearby skin may turn blue or reddish and appear to have a rash, or to be bruised. Secondary angiosarcoma (diagnosed in a patient who has already been treated for breast cancer) may feel like a hard, painless mass in the breast, skin may be blue or red over the mass, and there may be some swelling and bumpiness to some tumors. Some patients report feeling a tender, or even painful breast mass, depending on the size of the tumor.

Tests Used to Diagnose Breast Angiosarcoma:

  • Mammogram – an angiosarcoma will appear to have a fuzzy outline and will not have spiky protrusions (spikes are commonly seen on carcinomas)
  • Ultrasound - an angiosarcoma will show up well on an ultrasound, with clear borders that may be bumpy
  • Breast MRI – this type of tumor will show up on an MRI, revealing the affected blood vessels and surrounding tissue
  • Skin punch biopsy – a sample of affected skin will be taken and given a careful examination in the lab, to distinguish this from other, similar cancers
  • Open surgical biopsy – to get a larger sample of skin and tumor for lab testing

Angiosarcoma Grows and Spreads Quickly:

This type of breast cancer is aggressive, and your prognosis will depend on the stage at which it is caught, how far it has spread at the time of diagnosis, and how aggressively it is treated. Angiosarcoma of the breast can spread through your blood system to your lungs, liver, bones, skin, and your other breast. Your brain, ovaries, and lymph nodes may also be affected by the metastasis of angiosarcoma. This type of breast cancer has a high rate of recurrence. A diagnosis of breast angiosarcoma usually has a poor prognosis, and only 10% to 27% of patients will survive this cancer by 5 years.

Treatments for Breast Angiosarcoma:

  • Lumpectomy – surgery to remove the tumor and a wide margin of surrounding tissue (helps prevent recurrence)
  • Mastectomy – surgery to remove all of the breast tissue
  • Chemotherapy – most angiosarcomas will not benefit from chemo, but some may

Outlook on Prevention and Treatment:

Research is being done on new ways to treat angiosarcoma of the breast, so that it may be better controlled, providing patients with better survival and quality of life. Hyperfractionated irradiation (smaller, more frequent doses of radiation) may help prevent local recurrence. Hyperthermia (treating tumors with heat), interleukin-2 (a drug that boosts your immune system), and anti-angiogenesis therapy (such as Avastin), are considered experimental treatments and are available only in a clinical trial at this time.

Sources:

Radiology 2007;242:725-734. Mammary Angiosarcomas: Imaging Findings in 24 Patients. Wei Tse Yang, MD, et al.

American Cancer Society. What is Breast Cancer? Angiosarcoma. Revised: 09/13/2007.

Iranian Journal of Radiology, Winter 2006, 3(2). Angiosarcoma of the Breast; Report of a Case and Literature Review. D. Farrokh MD., J. Hashemi MD., and B. Zandi MD. PDF file format.

Cancer. 2003 Apr 15;97(8):1832-40. Angiosarcoma after breast-conserving therapy. Monroe AT, Feigenberg SJ, Mendenhall NP.

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  5. Types of Breast Cancer
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