Haemorrhaging lesion in the breast: is there a role for embolisation?

A Case of Life-Threatening Bleeding Due to a Locally Advanced Breast Carcinoma Successfully Treated with Transcatheter Arterial Embolization

Locally advanced breast cancer (LABC) may rarely present with acute severe bleeding. A case report dealing with transcatheter arterial embolization to control acute bleeding in a patient with a voluminous ulcerated breast mass is described. Our findings confirm that the endovascular approach is effective in such patients in order to stabilize the patient whenever conventional treatments have failed or bleeding may be life-threatening.

Multidisciplinary approach to chest wall reconstruction in primary breast angiosarcoma resection

Angiosarcomas account for less than 1% of primary breast cancers. Typically, they occur in young women with a low-risk personal or family history. Diagnosis, resection and reconstruction require a multidisciplinary team of breast surgeons, oncologists and plastic reconstructive surgeons. Cross-disciplinary awareness among these specialities enables dimensional patient treatment. We report a case of primary angiosarcoma of the breast in a 33-year-old woman, with no previous radiotherapy exposure, treated with a radical mastectomy and chest wall reconstruction with a deep inferior epigastric perforator (DIEP) Flap. There is a general consensus in current literature regarding the difficulty for curative treatment in angiosarcomas. There is a requirement for surgical intervention to be aggressive to ensure oncological clearance. Subsequently, the extensive reconstructive task proves a major procedure for any plastic surgeon. DIEP autologous flap chest wall reconstruction accompanying radical mastectomy can be used in efforts to eradicate risks of deep margin incomplete excision in breast angiosarcomas. This case report and review of the current literature aim to provide guidance for colleagues managing angiosarcomas and also highlight the versatility of the DIEP flap.

Transcatheter Arterial Embolization for Controlling Severe Bleeding From Recurrent Locally-Advanced Breast Cancer

One of the rare but most challenging issues in the management of the locally-advanced breast cancer (LABC) is life-threatening bleeding from the fungating and/or ulcerating focus (foci) of these tumors. Breast surgeons may need the assistance of interventional radiologists to solve this urgent condition if surgery cannot provide sufficient benefit. Herein, we report a case of recurrent locally-advanced breast cancer that presented with sudden severe bleeding, which was stopped by an interventional radiologist via transcatheter arterial embolization (TAE). In addition, we evaluate the role of interventional radiology in patients with breast cancer who present with bleeding from the breast by reviewing the relevant literature.

Recurrent Primary Angiosarcoma of the Breast Presenting as Kasabach-Merritt Syndrome: A Case Report and Review of Literature

Angiosarcoma of the breast is an unusual tumour. The diagnosis of this condition is difficult clinically, pathologically and radiologically. Treatment includes surgery followed by chemoradiation. The tumour is notorious for its recurrence and is generally associated with poor prognosis. Kasabach-Merritt syndrome also is a very rare entity seen primarily in infants with vascular malformations and carries a poor prognosis. In this report, the authors describe a patient with recurrent primary angiosarcoma of the breast, which presented as Kasabach-Merritt syndrome.