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Radiation-induced Angiosarcoma — SCE Medical Oncology MCQ

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HardBreast CancerRadiation-induced AngiosarcomaSCE Medical Oncology

A 55-year-old woman treated for breast cancer 8 years ago with mastectomy and adjuvant radiotherapy develops purple-red nodules in the irradiated skin of her chest wall. Biopsy confirms angiosarcoma. What is the key risk factor?

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Correct answer: C — Prior radiotherapy — radiation-induced angiosarcoma (Stewart-Treves syndrome equivalent) typically develops 5-10 years post-RT

Radiation-associated angiosarcoma of the breast/chest wall is a rare but serious late complication of breast radiotherapy, typically developing 5-10 years after treatment. It presents as multifocal purple-red papules/nodules in the irradiated field. Treatment is wide excision ± re-irradiation (hyperfractionated). Prognosis is guarded. It must be distinguished from atypical vascular lesions (AVL) which are benign. Weekly paclitaxel has activity in metastatic angiosarcoma.

Reference: ESMO 2024 Soft Tissue Sarcoma Guidelines; NICE NG101