Breast Angiosarcoma: A Rare Anatomical Presentation of a Neglected Case

Radiation-associated angiosarcoma of the breast (RAAS) is an infrequent and aggressive complication of breast-conserving therapy and adjuvant radiotherapy.Early diagnosis is challenging because of its nonspecific clinical manifestation.A 91-year-old woman presented with a progressively evolving cutaneous lesion of the left breast 6 years after breast-conserving surgery and adjuvant radiotherapy for hormone receptor-positive breast carcinoma.Histopathological examination showed an infiltrative malignant vascular neoplasm composed of atypical epithelioid and spindle cells.Immunohistochemistry demonstrated diffuse positivity for CD31 and FLI1 and negativity for CD34, CKAE1/AE3, Cam5.2, GATA3, and HHV8, confirming the diagnosis of radiation-related angiosarcoma and excluding recurrent breast carcinoma.This case highlights the importance of considering RAAS in patients presenting with new skin lesions within previously irradiated breast tissue.Prompt biopsy and comprehensive histopathological evaluation are essential for establishing a prompt diagnosis and guiding appropriate management, even in very elderly patients.