Cutaneous breast angiosarcoma after conserving treatment of breast cancer.

Cutaneous angiosarcoma is a rare malignancy that sometimes occurs as a late sequela of breast conservation therapy. We report on a 79-year-old female who developed well-differentiated angiosarcoma in a lymphedematous left breast 5.5 years after surgery and radiotherapy for early invasive ductal breast cancer. The initial appearance was very similar to late radiation dermatitis, and histologically interpreted as scar tissue with atypical vascular lesion. The lesion progressed further, and was clinically suspicious for angiosarcoma. Thus, a second biopsy was taken which confirmed the diagnosis. A complete mastectomy removed all the tumor with clear margins. However, within a period of 16 months she presented four local recurrences which were treated by wide local excision. At present, the patient is free of locally recurrent tumour for 7 months. The few cases of breast angiosarcoma after breast conservation therapy reported so far demonstrate that these lesions are difficult to diagnose due to their rarity and their highly variable and benign appearance, which sometimes may mimic radiation-induced cutaneous changes. Since chronic lymphedema possibly contributes to the development of angiosarcoma, long-term clinical surveillance of these patients is recommended. Biopsies should be taken if new skin lesions occur.

[Trial of systemic postoperative irradiation of breast cancer]. / Versuch einer systemischen postoperativen Bestrahlung des Mammakarzinoms.

Most of all women submitted to radical operation for a loco-regionally advanced mammary carcinoma show a fateful latent formation of remote metastases necessitating a total body treatment. In a pilot study twenty patients underwent instead of adjuvant chemotherapy an irradiation of both the upper and lower body part administered in two sessions with a dose of 8 Gy to the lung and the median body line, respectively, in order to reduce or to destroy micrometastases. The irradiations were given in one day at intervals of three to four weeks. They were well tolerated. A negative influence on the disease has not yet been observed, however, the manifestation of metastases seems to be delayed. The method is not expensive and involves little inconvenience for the patient, on the other hand it still seems to be capable of improvement.