When one tumour hides another… Multirecurrent bilateral radiation-induced breast angiosarcoma associated with recurrence of mucinous invasive ductal carcinoma

We report the case of a 59-year-old patient who presented with right mastodynia and breast induration for 4 weeks, in the context of conservative treatment of invasive ductal cancer of the mucinous type 8 years ago associated with hormone therapy and radiotherapy sessions. Ultrasound showed thickening of the dermis and densification of the breast stroma, which led to further exploration, including MRI, ultrasound-guided microbiopsies and a PET-CT, confirming the diagnosis of radiation-induced breast angiosarcoma. Left preventive mastectomy revealed bilateral radiation-induced breast angiosarcoma. The one-year follow-up MRI showed the presence of suspicious nodular lesions on the right chest wall, which proves to be a recurrence of the primary breast carcinoma, while the breast angiosarcoma will also recur several times on the right. We will detail the radiological, anatomopathological, therapeutic and prognostic particularities of radiation-induced breast angiosarcoma.