Angiosarcoma of the breast: a new therapeutic approach?

INTRODUCTION: Angiosarcomas are highly malignant endothelial cell tumors with poor prognosis. Thesecan be due to breast cancer itself or to subsequent therapeutic modalities. No evidence-based guidelinesexist concerning the ideal treatment of angiosarcomas.PRESENTATION OF THE CASE: We report the case of a 76-year-old woman who developed an exuberantand aggressive post radiation angiosarcoma of the breast and discuss different aspects of therapy forthis disease. A total left mastectomy was performed, followed by a right mastectomy. The lesions intothe chest wall, and multiple abdominal skin nodules were treated with local Electrochemotherapy (ECT)with intravenous bleomicin. DISCUSSION: No evidence-based guidelines exist concerning the ideal treatment of angiosarcomas. Elec-trochemotherapy (ECT) is an efficient palliative treatment of cutaneous and subcutaneous tumor nodules.It consists of the combination of a cytotoxic drug and electroporation, using appropriate electrical param-eters; destabilization of the membrane is reversible, ensuring a high survival of permeabilized cells andthe delivery of non-permeant molecules inside the cell. CONCLUSION: Due to the rarity of the disease, prospective studies concerning adjuvant or neoadjuvanttherapy are limited and no evidence-based guidelines exist. The response to chemotherapy seems to bepoor. Treatment with ECT in addition to systemic chemotherapy achieves a complete response in all the lesions and improving patient body image perception.