Angiosarcoma and other vascular tumors of the breast

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Abstract
Vascular tumors of the breast with the exception of perilobular hemangiomas, are generally considered to be malignant. The pathologic and clinical features of 40 patients with angiosarcoma of the breast and 12 with other vascular tumors of the breast were reviewed. Three general histologic patterns of growth were identified among the angiosarcomas and correlated closely with prognosis. Whereas 10 of the 13 patients in histologic group I were alive and free of disease with an average follow-up of nearly 6 yr, only 2 of 16 group III patients were free of disease, and 14 have died. The 6 group II patients had a survival similar to those in group I. In this series the disease-free survival at 3 yr was 41% and at 5 yr 33%, much better than that reported in previous reviews of mammary angiosarcoma. Adjuvant chemotherapy, specifically actinomycin D apparently is effective in some and possibly all patients with angiosarcoma of the breast. The 12 other vascular lesions had distinctly different morphologic features, a benign clinical course, and should probably not be viewed as angiosarcomas. Total excision of all vascular lesions of the breast is essential to determine the diagnosis and the appropriate therapy.

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