RESUMO
INTRODUCTION AND IMPORTANCE: Primary angiosarcoma of the breast is a rare malignancy with an associated poor prognosis due to its high rates of reoccurrence and metastasis It is most common in females presenting in their 3rd and 4th decades with no evidence of hormonal dependency. Cases usually present with rapidly progressing non-tender breast lump. CASE PRESENTATION: A 75-year-old female referred for triple assessment of a rapidly enlarging right breast lump. The patient underwent multiple investigations for work-up and to aid in the diagnosis of a moderately differentiated angiosarcoma of the breast. CLINICAL DISCUSSION: Diagnostic dilemmas remain due to the non-specific findings on standard radiological investigations and high false-negative results on core-biopsy. Consideration should be made in those with a high clinical suspicion for magnetic resonance imaging and excisional biopsy. Although limited research, first line management of those without metastatic disease is radical surgery. CONCLUSION: Breast primary angiosarcoma is a rare entity in post-menopausal women that should be considered in the differentials of breast lumps. Standardized information is limited though current management includes local control with radical surgery. The role for neoadjuvant therapy, adjuvant radiotherapy or chemotherapy is still unclear.