{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T05:04:43Z","timestamp":1789621483428,"version":"build-2803163510"},"reference-count":20,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T00:00:00Z","timestamp":1789603200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Breast angiosarcoma (AS) is an extremely rare and aggressive malignancy with no standardized treatment guidelines. We report an exceptional case of metachronous bilateral primary and secondary AS in a single patient, highlighting the diagnostic and therapeutic challenges posed by this disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>A patient underwent surgical dissection for primary AS of the right breast. Seven months later, a primary AS was identified in the left breast. Four months after that, a secondary angiosarcoma also developed within the previously irradiated left chest wall and axilla. Postoperative pathology confirmed angiosarcoma in all resected specimens. Following multidisciplinary team discussion, the patient received simple mastectomy, adjuvant chemotherapy, and radiotherapy. Despite this multimodal approach, contrast-enhanced CT follow-up revealed rapid disease progression with distant metastases to the lungs, liver, spleen, bilateral adnexa, and bones. The patient ultimately died of respiratory failure secondary to severe pulmonary infection and atelectasis 22 months after the initial diagnosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This extraordinarily rare case of sequential bilateral primary and secondary breast AS underscores the aggressive biological behavior of this malignancy and the limitations of current therapeutic strategies. It highlights the urgent need for identifying specific diagnostic biomarkers and novel therapeutic targets to enable early detection and improve the dismal prognosis associated with this disease.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fonc.2026.1883637","type":"journal-article","created":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T04:45:09Z","timestamp":1789620309000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Case Report: Metachronous bilateral primary and secondary angiosarcoma of the breast"],"prefix":"10.3389","volume":"16","author":[{"given":"Shulian","family":"Zhuang","sequence":"first","affiliation":[{"name":"Department of Ultrasound, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine","place":["Guangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianxing","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Ultrasound, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine","place":["Guangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miao","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Ultrasound, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine","place":["Guangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yunsi","family":"Lai","sequence":"additional","affiliation":[{"name":"Department of Ultrasound, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine","place":["Guangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ling","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Ultrasound, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine","place":["Guangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,17]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1155\/2021\/5542786","article-title":"Contrast-enhanced mammography in the diagnosis of breast angiosarcoma","volume":"2021","author":"Grisaru-Kacen","year":"2021","journal-title":"Case Rep Radiol"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1097\/PAS.0b013e318176dbc7","article-title":"Primary angiosarcoma of the breast: clinicopathologic analysis of 49 cases, suggesting that grade is not prognostic","volume":"32","author":"Nascimento","year":"2008","journal-title":"Am J Surg Pathol"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1016\/j.tranon.2022.101385","article-title":"Differences in potential key genes and pathways between primary and radiation-associated angiosarcoma of the breast","volume":"19","author":"Wang","year":"2022","journal-title":"Transl Oncol"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1177\/1066896920930100","article-title":"Secondary angiosarcoma with C-MYC amplification following prophylactic bilateral mastectomy and autologous breast reconstruction: report of a case and review of the literature","volume":"29","author":"Webb","year":"2021","journal-title":"Int J Surg Pathol"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijscr.2016.05.015","article-title":"Primary breast angiosarcoma in a young woman","volume":"24","author":"Iacoponi","year":"2016","journal-title":"Int J Surg Case Rep"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1016\/j.clon.2019.01.009","article-title":"Cutaneous angiosarcoma secondary to lymphoedema or radiation therapy: a systematic review","volume":"31","author":"Co","year":"2019","journal-title":"Clin Oncol (R Coll Radiol)"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1007\/s10549-011-1931-2","article-title":"Primary and secondary angiosarcomas of the breast: a single institution experience","volume":"132","author":"Fraga-Guedes","year":"2012","journal-title":"Breast Cancer Res Treat"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1186\/s12907-017-0055-y","article-title":"Primary breast angiosarcoma: a rare presentation of rare tumor","volume":"17","author":"Abbad","year":"2017","journal-title":"BMC Clin Pathol"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(19950615)75:12<2867::aid-cncr2820751212>3.0.co;2-8","article-title":"Use of immunohistochemical procedures in diagnosing angiosarcoma: evaluation of 98 cases","volume":"75","author":"Ohsawa","year":"1995","journal-title":"Cancer"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1016\/j.canrad.2015.01.001","article-title":"Can c-myc amplification reliably discriminate postradiation from primary angiosarcoma of the breast","volume":"19","author":"La\u00e9","year":"2015","journal-title":"Cancer Radiother"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1111\/his.14433","article-title":"The impact of MYC amplification on clinicopathologic features and prognosis of radiation-associated angiosarcomas of the breast","volume":"79","author":"Kuba","year":"2021","journal-title":"Histopathology"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1148\/radiology.183.3.1584913","article-title":"Angiosarcoma of the breast","volume":"183","author":"Liberman","year":"1992","journal-title":"Radiology"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2423060163","article-title":"Mammary angiosarcomas: imaging findings in 24 patients","volume":"242","author":"Yang","year":"2007","journal-title":"Radiology"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.2174\/1573405616666201007161119","article-title":"Primary breast angiosarcoma: utilisation of pre-surgical magnetic resonance imaging (MRI) for accurate tumour characterisation and planning: a case report and literature review","volume":"17","author":"Mumin","year":"2021","journal-title":"Curr Med Imaging Rev"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1111\/tbj.14272","article-title":"Primary bilateral angiosarcoma of the breast treated with neoadjuvant chemotherapy combined with propranolol","volume":"27","author":"Luczynska","year":"2021","journal-title":"Breast J"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1007\/s00595-010-4341-x","article-title":"Breast angiosarcoma that is not related to radiation exposure: a comprehensive review of the literature","volume":"41","author":"Kaklamanos","year":"2011","journal-title":"Surg Today"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1111\/j.1075-122x.2006.00280.x","article-title":"Primary angiosarcoma of the breast: do enlarged axillary nodes matter","volume":"12","author":"Losanoff","year":"2006","journal-title":"Breast J"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-012-2755-y","article-title":"Long-term outcomes in patients with radiation-associated angiosarcomas of the breast following surgery and radiotherapy for breast cancer","volume":"20","author":"Torres","year":"2013","journal-title":"Ann Surg Oncol"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1007\/s10549-019-05432-4","article-title":"Primary and secondary breast angiosarcoma: single center report and a meta-analysis","volume":"178","author":"Abdou","year":"2019","journal-title":"Breast Cancer Res Treat"},{"key":"B20","doi-asserted-by":"publisher","first-page":"60","DOI":"10.1186\/s13256-023-03791-7","article-title":"Bilateral primary angiosarcoma of the breast: a case report","volume":"17","author":"Ooe","year":"2023","journal-title":"J Med Case Rep"}],"container-title":["Frontiers in Oncology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2026.1883637\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T04:45:34Z","timestamp":1789620334000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2026.1883637\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,17]]},"references-count":20,"alternative-id":["10.3389\/fonc.2026.1883637"],"URL":"https:\/\/doi.org\/10.3389\/fonc.2026.1883637","relation":{},"ISSN":["2234-943X"],"issn-type":[{"value":"2234-943X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,17]]},"article-number":"1883637"}}