Management of radiation-induced angiosarcoma of the breast with total mastectomy and superficial inferior epigastric artery flap reconstruction: a case report

Abstract

Background: Radiation-induced angiosarcoma of the breast is a rare but serious long-term complication of radiation, often from adjuvant therapy for previous breast cancer treatment. Early lesions typically appear benign and are often misattributed to breast trauma, however the disease is rapidly progressive and has a high recurrence rate and poor prognosis. Common imaging modalities such as mammography and ultrasound are often not sensitive, though magnetic resonance imaging may be more reliable. Once the diagnosis is confirmed via histopathologic evaluation of a core-needle or punch biopsy, surgical treatment should not be delayed. Reconstruction with free flap provides an advantage over other reconstructive techniques by allowing for adequate coverage of the large defect left by maximal resection of previously-irradiated tissue with ideal oncologic and wound healing outcomes.