Primary Breast Angiosarcoma : Prognosis

Comments:
Prognosis of Primary Angiosarcoma of Breast: The prognosis is poor. The tumor shows tendency to local recurrences, distant metastasis, and shortened survival time. More than 50% of cases have metastases at the time of diagnosis. The usual sites of metastases are bone, lung, liver, skin, and contralateral breast. Lymph node metastasis occur in less than 10% of cases. The median time between diagnosis and disease-related death is 2 to 3 years. Overall 5-yr survival is 45% to 60%.

The prognostic implications of tumor grade are controversial. Several studies have shown conflicting conclusions. Some studies show better survival with low and intermediate grades and poor survival with high-grade tumors. Others did not find an association between grade and outcome.

The image shows epithelioid angiosarcoma of breast (primary). These tumors are composed of solid sheets of large epithelioid cells with abundant eosinophilic or amphophilic cytoplasm, vesicular nuclei, and prominent nucleoli. Increased mitotic activity, hemorrhage, and necrosis are commonly present. Usually, there is no prominent vessel formation, although a few intracytoplasmic lumina with red blood cells may be seen.