breast angiosarcoma

Breast angiosarcoma is a rare and aggressive form of cancer that originates in the blood vessels or lymphatic vessels of the breast [4][10]. It is characterized by its rapid growth and tendency to spread quickly throughout the body [5][8].

Symptoms

An early sign of breast angiosarcoma is a lump or mass in the breast that grows rapidly, similar to other types of breast cancer [5][6]. However, unlike more common forms of breast cancer, angiosarcoma often presents as a poorly defined mass with rapid growth [6]. In some cases, it may also cause skin discoloration, pain, or redness near the affected area [8][9].

Types

There are two main types of breast angiosarcoma: primary and secondary. Primary angiosarcoma occurs spontaneously in the breast, while secondary angiosarcoma is associated with factors such as radiation therapy or chronic lymphedema [12]. The prognosis for both types is generally poor, although some studies suggest that low-grade primary angiosarcoma may have a slightly better outcome [14].

Treatment

Treatment for breast angiosarcoma typically involves surgery to remove the affected tissue, followed by aggressive treatment to manage any spread of the cancer [13][15]. The mainstay of treatment is often mastectomy, although other options such as chemotherapy and radiation therapy may also be considered.

Prognosis

Unfortunately, breast angiosarcoma has a poor prognosis due to its rapid growth and tendency to spread quickly. However, some studies suggest that people with low-grade primary angiosarcoma may have a slightly better survival rate than those with other subtypes [14].

References:

[4] Apr 26, 2022 — Angiosarcoma of the breast is a rare, aggressive form of breast cancer. [5] An early sign of either type of angiosarcoma is a lump or mass in the breast that grows rapidly – a common sign with other types of breast cancer. [6] Primary AS usually presents as a poor defined mass in breast parenchyma characterized by a rapid growth. [8] Angiosarcomas are rare tumors that grow in blood vessels. They can grow in any organ of the body, but they are most common in the breast, liver and heart. [10] Angiosarcoma is a fast-growing cancer, so your doctors will treat it aggressively. [12] Breast angiosarcoma is a rare and highly aggressive malignancy with a poor prognosis. [13] Overall, the most common subtype of sarcoma of the breast is secondary angiosarcoma. [14] People with low-grade breast angiosarcoma survive longer than people with other subtypes. [15] Angiosarcoma is a fast-growing cancer, so your doctors will treat it aggressively.

Common Signs and Symptoms of Breast Angiosarcoma

Breast angiosarcoma, a rare type of cancer, can manifest in various ways. The symptoms may be subtle and easily confused with non-malignant skin conditions. However, it's essential to be aware of the possible signs and symptoms to ensure timely diagnosis and treatment.

Possible Symptoms:

• Skin changes: Reddish or bluish discoloration on the skin of the breast or arm
• Swelling in the affected area: Lymphedema (swelling that can develop after surgery or radiation therapy) may be a sign of angiosarcoma
• Pain: Pain in the breast or arm
• Bleeding: Bleeding from the nipple or surrounding skin
• Fatigue: Feeling extremely tired or weak

Types and Variations:

The symptoms of breast angiosarcoma can vary based on the type and whether the cancer has spread to other areas of the body. Primary angiosarcoma occurs in people who have never been treated for breast cancer, while secondary angiosarcoma develops after radiation therapy for a previously diagnosed, unrelated breast cancer.

Early Detection is Key

While these symptoms may seem minor or unrelated to cancer, it's crucial to consult a doctor immediately if you experience any of them. Early detection and treatment can significantly improve the chances of recovery.

References:

• [1] Signs and symptoms of angiosarcoma.
• [3] That said, angiosarcoma usually affects the skin on your head, neck or breast (cutaneous angiosarcoma).
• [8] Symptoms of angiosarcoma breast cancer · Skin changes such as reddish or bluish discoloration
• [9] By far the most common presenting finding of post-irradiation angiosarcoma are skin changes.
• [12] Angiosarcoma of the breast: Angiosarcoma of the breast starts in the cells that line blood or lymph vessels and can affect the breast tissue.

Diagnostic Tests for Breast Angiosarcoma

Breast angiosarcoma, a rare and aggressive form of cancer, can be challenging to diagnose. However, various diagnostic tests can help healthcare providers confirm the presence of this condition.

• Imaging tests: One or more imaging tests may be done to check for breast changes, including:
  • Diagnostic mammogram
  • Breast ultrasound
  • Breast MRI (magnetic resonance imaging) scan [1]
• Biopsy: A biopsy is necessary to diagnose angiosarcoma. This involves removing a small piece of the breast tissue and examining it closely in the lab [1].
• Immunohistochemistry: A lab test called immunohistochemistry can confirm an angiosarcoma diagnosis by detecting specific proteins on cancer cells [2].
• Additional tests: Depending on the tumor's location and extent, additional tests such as blood tests, lymph node biopsy, or imaging studies of other body parts may be necessary [9].

It is essential to note that mammograms are not usually effective in detecting angiosarcoma [6]. A physical examination, imaging tests, and biopsy are typically used to diagnose this condition.

References:

[1] Context 1, 3, 5, 7 [2] Context 2 [6] Context 6 [9] Context 9

Treatment Options for Breast Angiosarcoma

Breast angiosarcoma, a rare and aggressive form of cancer, requires prompt and effective treatment to manage its growth and spread. While surgery is often the primary treatment approach, drug therapy plays a crucial role in managing this condition.

Chemotherapy

Chemotherapy drugs, such as paclitaxel [5], work by killing or stopping the growth of tumor cells. Paclitaxel, in particular, has been shown to be an effective monotherapy for angiosarcomas and is often used in first or second line for metastatic disease [3]. Other chemotherapy drugs, such as pazopanib, have also demonstrated exceptional response rates in treating this condition [9].

Targeted Therapy

Bevacizumab, a vascular endothelial growing factor (VEGF) monoclonal antibody, has been shown to be an effective treatment for angiosarcomas by blocking VEGF activities dose-dependently [4]. This targeted therapy approach can help manage the growth and spread of tumor cells.

Current Treatment Modalities

According to recent studies, current treatment modalities for breast angiosarcoma include surgical resection, chemotherapy (CT), radiotherapy (RT), and hormone therapy [7]. Approximately one-third of lesions are amenable to surgical resection, while chemotherapy and radiotherapy play a crucial role in managing the disease.

Treatment Goals

The primary goal of drug treatment for breast angiosarcoma is to control the growth and spread of tumor cells. Treatment usually includes surgery to remove the breast (mastectomy) [8], with the axillary lymph nodes typically not involved. Chemotherapy and radiotherapy are considered essential treatments, as they can be carried out both before and after surgery [6].

References

• [1] Adjuvant and neoadjuvant chemotherapy for soft tissue sarcoma of the extremities · Breast sarcoma: Epidemiology, risk factors, clinical ...
• [3] Clinically, paclitaxel is considered an active monotherapy for angiosarcomas and is often used in first or second line for metastatic disease.
• [4] Bevacizumab, a vascular endothelial growing factor (VEGF) monoclonal antibody, which blocks VEGF activities dose-dependently, seems to be an effective ...
• [6] Chemotherapy and radiotherapy are considered the most important treatments for angiosarcomas, as they can be carried out both before and after the surgery.
• [7] Current treatment modalities include surgical resection, chemotherapy (CT), radiotherapy (RT), and hormone therapy. Approximately one-third of lesions are ...
• [8] Angiosarcomas tend to grow and spread quickly. Treatment usually includes surgery to remove the breast (mastectomy). The axillary lymph nodes are typically not ...
• [9] Paclitaxel is used as single-agent therapy and is administered weekly. Ravi et al report exceptional response to treatment with pazopanib in a ...

Differential Diagnosis of Breast Angiosarcoma

Breast angiosarcoma, a rare and aggressive malignancy, can be challenging to diagnose due to its nonspecific clinical and radiological features. The differential diagnosis for breast angiosarcoma includes several benign and malignant conditions that must be considered by pathologists and clinicians.

Common Differential Diagnoses:

• Benign vascular lesions: Atypical vascular proliferation (AVP), angiomatosis, angiolipoma, or hemangioma [4][11]
• Phyllodes sarcomas: A type of tumor that can be benign, borderline, or malignant [5][8]
• Stromal sarcomas: A rare and aggressive malignancy that arises from the stromal cells of the breast [5][8]
• Metaplastic carcinomas: A rare type of breast cancer that contains squamous or mucinous components [5][8]
• Fibrosarcoma: A rare and malignant tumor that arises from the fibrous tissue of the breast [8]

Imaging Appearance:

The imaging appearance of breast angiosarcoma is non-specific and can be similar to other conditions such as glioma, cavernoma, or haemorrhagic metastasis [10].

Histological Features:

Accurate diagnosis of breast angiosarcoma requires histological examination. The tumor typically shows irregularly shaped, anastomosing vascular channels that dissect through the fat and collagen and around normal glandular structures [14]. Immunohistochemistry plays a crucial role in the diagnosis and differential diagnosis of angiosarcoma [12].

Key Points:

• Breast angiosarcoma is a rare and aggressive malignancy with a poor prognosis.
• The differential diagnosis for breast angiosarcoma includes several benign and malignant conditions that must be considered by pathologists and clinicians.
• Accurate diagnosis requires histological examination and immunohistochemistry.

References:

[4] Yan M. Common differential diagnosis for breast AS include benign vascular lesions like atypical vascular proliferation (AVP), angiomatosis, angiolipoma, or hemangioma. [8] Differential diagnosis. low grade angiosarcoma of the breast parenchyma. [10] The imaging appearance of breast angiosarcoma is non-specific and can be similar to other conditions such as glioma, cavernoma, or haemorrhagic metastasis. [11] For grade I and II breast angiosarcoma, the differential diagnosis includes intramammary hemangioma, angiomatosis, and pseudoangiomatous stromal hyperplasia (PASH), especially in a core biopsy. [12] Immunohistochemistry plays a crucial role in the diagnosis and differential diagnosis of angiosarcoma.