What are the other Names for this Condition? (Also known as/Synonyms)

• Atypical Vascular Proliferations of Breast
• Mammary Atypical Vascular Lesions
• Mammary Atypical Vascular Proliferations

What is Atypical Vascular Lesions of Breast? (Definition/Background Information)

• Atypical Vascular Lesions of Breast are small (numerous) lesions seen on the skin of the breast post radiation treatment. Also known as Atypical Vascular Proliferations of Breast, these lesions are strictly confined to the area of irradiation and may arise after a few years of radiation therapy
• They are categorized into the following subtypes:
  • Lymphatic atypical vascular lesion, resembling lymphangioma
  • Vascular atypical vascular lesion, resembling hemangioma or hobnail hemangioma
• A diagnosis of the condition may include biopsy of these skin lesions in order to exclude angiosarcoma (a malignancy) that is known to arise at post-radiation therapy sites
• The treatment of Atypical Vascular Proliferations of Breast may commonly involve a surgical removal of the lesions. The outcomes are generally good, but it may not be possible to prevent the formation of new lesions

Who gets Atypical Vascular Lesions of Breast? (Age and Sex Distribution)

• Atypical Vascular Lesions of Breast are uncommon and may be seen in individuals of any age group, predominantly in females
• Most cases are noted in women in the 55 to 65 years’ age group
• The condition can affect individuals of all races and ethnic backgrounds

What are the Risk Factors for Atypical Vascular Lesions of Breast? (Predisposing Factors)

• Atypical Vascular Lesions of Breast are only observed in the background of radiation therapy either for breast cancer (mostly) or for other cancers involving the chest region
• The risk increases with greater intensity and longer duration of radiation treatment
• An increased risk is seen in the setting of surgery for breast cancer (mastectomy) followed by radiation therapy

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases one’s chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Atypical Vascular Lesions of Breast? (Etiology)

The exact cause of development of Atypical Vascular Lesions of Breast is presently not well-understood.

• The cause is directly related to radiation treatment to the breast region (mostly administered in the setting of a malignancy)
• The lesions may arise after 3 to 4 years of radiotherapy (sometimes even after 20 years); but in some individuals, it can be seen within 12 months
• Nevertheless, the lesions may appear at any site on the body that underwent radiation therapy

What are the Signs and Symptoms of Atypical Vascular Lesions of Breast?

Atypical Vascular Lesions of Breast may exhibit the following signs and symptoms.

• Presence of small brown to red lesions (mostly in the form of papules and occasionally plaques)
• These are typically multiple in numbers and may be 5 mm in size each
• Most lesions are confined to the superficial skin layers; rarely, the deeper layers of skin are affected
• One or both breasts may be affected
• The condition is generally painless

How is Atypical Vascular Lesions of Breast Diagnosed?

Atypical Vascular Lesions of Breast may be diagnosed in the following manner:

• Complete physical examination with comprehensive medical history evaluation, including checking for history of radiation therapy to the breast/chest region
• Breast exam
• Mammogram (if necessary): A mammogram uses X-rays to provide images of the breast
• Breast ultrasound scan: Using high-frequency sound waves to produce images of the breast
• Computerized tomography (CT) or magnetic resonance imaging (MRI) scan of the breast
• Tumor biopsy:
  • A biopsy of the tumor (lesion) is performed and sent to a laboratory for a pathological examination. A pathologist examines the biopsy under a microscope. After putting together clinical findings, special studies on tissues (if needed) and with microscope findings, the pathologist arrives at a definitive diagnosis. Examination of the biopsy under a microscope by a pathologist is considered to be gold standard in arriving at a conclusive diagnosis
  • Biopsy specimens are studied initially using Hematoxylin and Eosin staining. The pathologist then decides on additional studies depending on the clinical situation
  • Sometimes, the pathologist may perform additional studies, which may include immunohistochemical stains and molecular studies to assist in the diagnosis

Unlike angiosarcomas that develop in the background of radiation treatment, Atypical Vascular Lesions of Breast do not show any MYC gene amplification or overexpression. A breast biopsy is important to confirm the diagnosis and exclude malignancy. Hence, molecular studies are helpful in distinguishing atypical vascular lesions from malignant vascular proliferations such as angiosarcoma.

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Atypical Vascular Lesions of Breast?

There may not be any significant complications of Atypical Vascular Lesions of Breast. In some cases, the following may be noted:

• Emotional stress from the skin condition
• Recurrence of the condition, especially from an incomplete removal of the lesions

How is Atypical Vascular Lesions of Breast Treated?

The treatment of Atypical Vascular Lesions of Breast may involve:

• Symptomatic treatment, as needed
• Surgical excision is the preferred method to remove the lesions
• Skin grafting may be recommended for cosmetic concerns

Currently, no specific guidelines are available to effectively treat the condition.

How can Atypical Vascular Lesions of Breast be Prevented?

• Currently, there are no specific preventive measures available for Atypical Vascular Lesions of Breast.
• Individuals who have undergone treatment for breast cancer or malignancies in the chest region may be recommended regular dermatological checkups

What is the Prognosis of Atypical Vascular Lesions of Breast? (Outcomes/Resolutions)

The prognosis of Atypical Vascular Lesions of Breast is generally good since it is a benign condition.

• More lesions may develop over time and local recurrences have also been observed; however, atypical vascular lesions are typically benign in a vast majority of people
• Rare transformations to angiosarcomas are reported, but these are presently not well-confirmed

Additional and Relevant Useful Information for Atypical Vascular Lesions of Breast:

Various terms have been used to describe atypical vascular lesions that are presently not acceptable. These include:

• Acquired progressive lymphangiomas
• Atypical hemangiomas
• Benign lymphangioendotheliomas
• Benign lymphangiomatous papules
• Lymphangioma circumscriptum

The following DoveMed website links are useful resources for additional information:

https://www.dovemed.com/healthy-living/womens-health/

https://www.dovemed.com/diseases-conditions/cancer/