breast angiomatosis

Breast Angiomatosis: A Rare Benign Vascular Lesion

Breast angiomatosis, also known as diffuse dermal angiomatosis of the breast (DDAB), is a rare and benign vascular lesion that affects the breast tissue. It is characterized by the proliferation of small- to medium-sized blood vessels in the skin and underlying tissues of the breast.

Clinical Presentation

The clinical presentation of breast angiomatosis typically includes:

• Painful, non-healing, reticulated, violaceous, centrally ulcerating lesions or plaques on the breasts [8][9]
• Prominent vessels surrounding the lesion [9]
• The condition can be associated with large pendulous breasts, obesity, and a history of smoking [10]

Histological Features

The histological features of breast angiomatosis include:

• A proliferation of small- to medium-sized blood vessels in the skin and underlying tissues of the breast [7][13]
• No endothelial atypia, stratification or notable mitotic activity [13]
• Large dilated vascular channels permeate the breast but show exquisite sparing of the terminal duct lobular units, unlike angiosarcoma [13]

Differential Diagnosis

Breast angiomatosis can be challenging to diagnose due to its rarity and similar features with more common malignant vascular tumors, such as angiosarcoma. Therefore, familiarity with angiomatosis in the differential diagnosis is essential.

References

[1] Krell et al. (1994) - First described diffuse dermal angiomatosis as a subtype of reactive angioendothelialiomatosis. [2] Mekhail et al. (2017) - Described angiomatosis of the breast as an extremely rare, benign vascular lesion. [3] Yang et al. (2006) - Described diffuse dermal angiomatosis as a rare condition affecting both sexes. [4] Reticulated erythematous to violaceous patches involving both breasts, with ulceration on the right side [11] [5] A biopsy was performed since angiosarcoma was suspected [11] [6] Diffuse dermal angiomatosis of the breast (DDAB) is a rare benign condition that is most common among middle-aged, overweight women with macromastia and a history of vaso-occlusive disorders and/or smoking [12] [7] Angiomatosis: Very rare benign vascular proliferation involving large areas of breast parenchyma [13] [8] Clinically, patients present with painful, non-healing, reticulated, violaceous, centrally ulcerating lesions or plaques on the breasts [8][9] [9] Prominent vessels surrounding the lesion [9] [10] The age range has been 20 to 62 years (mean age 47) and is most common among middle-aged, overweight women with macromastia and a history of vaso-occlusive disorders and/or smoking [10] [11] A biopsy was performed since angiosarcoma was suspected [11] [12] Diffuse dermal angiomatosis of the breast (DDAB) is a rare benign condition that is most common among middle-aged, overweight women with macromastia and a history of vaso-occlusive disorders and/or smoking [12] [13] Angiomatosis: Very rare benign vascular proliferation involving large areas of breast parenchyma Large dilated vascular channels permeate the breast but show exquisite sparing of the terminal duct lobular units, unlike angiosarcoma No endothelial atypia, stratification or notable mitotic activity. Carcinoma [13]

Common Signs and Symptoms of Breast Angiomatosis

Breast angiomatosis, also known as diffuse dermal angiomatosis (DDA), is a rare benign vascular lesion of the breast. The condition can present with various signs and symptoms, which are often similar to those of other breast conditions.

• Painful and Irritating Lesions: Breast angiomatosis typically manifests as painful, non-healing, reticulated, violaceous plaques or lesions on the breasts [4][5].
• Reticular Erythematous Plaques: The condition is characterized by the presence of reticular erythematous to violaceous plaques with a tendency to centrally ulcerate [5].
• Severe Intractable Breast Pain: Patients commonly present with severe intractable breast pain, which can be exacerbated by hypoxic conditions [5].
• Ulceration and Tenderness: Ulceration and tenderness are common symptoms of breast angiomatosis, particularly in the upper thigh area [2].

Other Possible Symptoms

In some cases, breast angiomatosis may also present with other symptoms, including:

• Mass in the Breast: A mass or lump in the breast can be a sign of breast angiomatosis, especially if it is accompanied by rapid growth during pregnancy [10].
• Sudden Rapid Growth: Sudden and rapid growth of the mass during pregnancy can be a symptom of gestational gigantomastia (GG), which is a rare disorder related to breast angiomatosis [7].

Important Notes

It's essential to note that these symptoms can also be indicative of other breast conditions, such as breast cancer. Therefore, if you experience any unusual symptoms or notice changes in your breasts, it's crucial to consult with a healthcare professional for proper evaluation and diagnosis.

References:

[1] by N Nguyen · 2020 · Cited by 12 [2] by H Yang · 2006 · Cited by 58 [3] by BJ Adams · 2012 · Cited by 9 [4] by P Shet · 2024 · Cited by 1 [5] by P Shet · 2024 · Cited by 1 [6] Angiomatosis is a rare benign vascular lesion of the breast defined by diffuse distribution of large, cystically dilated vascular spaces. [7] by KZ Young · 2023 · Cited by 5 [8] by F Frikha · 2018 · Cited by 17 [9] by P Shet · 2024 · Cited by 1 [10] The signs and symptoms of Angiomatosis of Breast may include the presence of a mass in the breast and sudden rapid growth of the mass during pregnancy.

Breast angiomatosis, also known as diffuse dermal angiomatosis (DDA), is a rare and benign vascular lesion that can be challenging to diagnose. While there are no specific diagnostic tests for breast angiomatosis, various imaging techniques and laboratory studies can help confirm the diagnosis.

Imaging Techniques:

• Ultrasound studies have been used to evaluate breast angiomatosis, showing diffuse symmetric breast edema without focal masses or evidence of malignancy [6][8].
• Doppler ultrasound has also been employed to characterize the lesions, although its diagnostic accuracy is limited [9].
• Magnetic resonance imaging (MRI) may be used in some cases to further evaluate the extent and characteristics of the lesion.

Laboratory Studies:

• Laboratory tests have been performed to rule out other clinical conditions that may mimic breast angiomatosis. These tests include:
  • Complete blood cell count
  • Blood chemistry panel
  • Lipid panel
  • Coagulation studies
  • Determination of antinuclear antibodies (ANA) [3][7]
• Fine-needle aspiration biopsy (FNAB) may be performed to determine if the tumor is malignant or benign, although it cannot definitively diagnose breast angiomatosis [14].

Specialized Diagnostic Tests:

• Immunohistochemistry analysis has been used in some cases to further characterize mammary angiomatosis and distinguish it from low-grade angiosarcoma (LGAS) [11].
• Histological examination of the lesion may also be performed to confirm the diagnosis.

It is essential to note that breast angiomatosis can mimic more common malignant vascular tumors, such as angiosarcoma. Therefore, familiarity with this condition in the differential diagnosis is crucial for accurate diagnosis and treatment planning.

Treatment Options for Breast Angiomatosis

Breast angiomatosis, also known as diffuse dermal angiomatosis (DDA), is a rare cutaneous vascular disorder that can affect the breast tissue. While there are limited studies on this condition, various treatment options have been explored to manage its symptoms.

Topical Propranolol: A case report published in 2023 by J Lorca-Spröhnle describes successful treatment of DDA with topical propranolol [2]. This suggests that topical application of propranolol may be a viable option for managing the condition.

Isotretinoin: Isotretinoin, a derivative of vitamin A, has been used to treat various skin conditions. In two case reports published in 2008 by MT Villa and 2015 by R Reusche, isotretinoin was used to treat DDA on the breast [3][4]. While results were equivocal, these studies suggest that isotretinoin may be considered as a treatment option.

Other Treatment Options: Conservative management with oral corticosteroids, pentoxifylline/aspirin, or isotretinoin has also been explored [6][7]. Additionally, bilateral reduction mammoplasty and other surgical interventions have been considered in some cases [5].

Anti-Angiogenic Agents: While not specifically targeting DDA, anti-angiogenic agents have been studied for their potential to inhibit cancer growth. However, ambivalent results in breast cancer studies raise questions about the effectiveness of these agents in treating DDA [10].

It is essential to note that each case of breast angiomatosis may require individualized treatment approaches, and more research is needed to determine the most effective management strategies.

References:

[2] Lorca-Spröhnle J. Diffuse dermal angiomatosis of the breast: a case report of successful treatment with topical propranolol. 2023.

[3] Villa MT. Two case reports describe treatment of the condition on the breast with isotretinoin. In one, the ultimate cosmesis was suboptimal owing to ...

[4] Reusche R. Adjunct medical therapy with agents such as isotretinoin, acetylsalicylic acid (aspirin), and pentoxifylline has been used in some cases.

[5] Bilateral reduction mammoplasty and other surgical interventions have been considered in some cases.

[6] Conservative management with oral corticosteroids, pentoxifylline/aspirin, or isotretinoin has also been explored.

[7] Surgical interventions may be necessary to manage symptoms and improve quality of life.

Differential Diagnosis of Breast Angiomatosis

Breast angiomatosis, also known as diffuse dermal angiomatosis of the breast (DDAB), is a rare benign vascular lesion that can be challenging to diagnose. The differential diagnosis for DD