Primary Epithelioid Angiosarcoma of the Breast Masquerading as Carcinoma

Here we report a case of primary epithelioid angiosarcoma (EAS) of the breast occurring in a 30-year-old woman. Following fine-needle asspiration cytology (FNAC) and tru-cut biopsy, the patient was initially diagnosed with mammary carcinoma and thereafter underwent modified radical mastectomy. Postoperative histopathologic examination and immunohistochemistry revealed a diagnosis of primary epithelioid angiosarcoma of the breast. The patient received postoperative radiotherapy to the chest wall and was started on adjuvant thalidomide. Preoperatively, EAS can be mistaken for carcinoma because it is difficult to appreciate the typical morphology on FNAC or tru-cut biopsy. Indeed, this is an area of potential diagnostic error because, nowadays, neoadjuvant therapy is often instituted after core biopsy of a breast mass. This case is being reported not only for its diagnostic difficulty, but also because of its rarity in English literature.