Primary Mammary Angiosarcoma in a Postmenopausal Woman: A Case Report.

BACKGROUND: Primary breast angiosarcoma (PAS) is a rare aggressive mesenchymal breast tumor, which predominantly affects young premenopausal women and is prone to misdiagnosis due to nonspecific clinical and imaging features. Surgical resection is the main treatment, while the efficacy of adjuvant chemoradiotherapy remains unclear. Targeted therapy represents a promising novel therapeutic direction. CASE: A 51-year-old postmenopausal woman presented with a rapidly enlarging left breast mass for over 3 months. Physical examination showed a 4 cm × 3 cm × 2 cm mass with a smooth surface, moderate mobility and no cutaneous changes. The lesion was radically resected via two-stage surgery, and the patient was diagnosed with stage I (T1N0M0) primary left breast angiosarcoma. The patient received sequential adjuvant chemotherapy with doxorubicin plus cyclophosphamide followed by paclitaxel. No recurrence or metastasis occurred during more than 5 years of follow-up. CONCLUSION: Different from conventional PAS predominantly occurring in young women, this atypical postmenopausal PAS has high concealment and diagnostic difficulty. This study summarizes the clinical characteristics and diagnostic pitfalls of this rare case, supplements the clinical and prognostic data of postmenopausal PAS, and helps improve clinicians' recognition of atypical PAS to avoid delayed diagnosis and treatment.