Angiomatosis of the Breast

Definition

• Very rare diffuse benign vascular process of the breast

Alternate/Historical Names

• Diffuse angiomatosis

Diagnostic Criteria

• Very rare, only five cases reported
  • Do not make this diagnosis without consultation
• Diffuse process
  • Surrounds ducts and lobules
  • No invasion into lobules
• Large irregular vascular spaces
  • No muscular wall
  • May have occasional anastomoses
• Lined by flat endothelium without atypia
• May have both blood and lymphatic channels
• Complete excision and examination is required for the diagnosis of any benign vascular lesion in the breast

Richard L Kempson MD
Robert V Rouse MD
Department of Pathology
Stanford University School of Medicine
Stanford CA 94305-5342

Original posting:: May 27, 2006

Supplemental studies

Immunohistology

• Supplemental stains not typically required

Differential Diagnosis

• Angiosarcoma
• Benign breast vascular lesions

Angiosarcoma of the Breast	Angiomatosis of the Breast
Variable patterns: channels, papillae, spindle cells	Uniform pattern of vessels
Usually a t least focal cytologic atypia	Cytologically bland
Invades lobules	Does not invade lobules
Frequent papillae and tufting	No papillae or tufting

Angiomatosis	Perilobular Hemangioma	Hemangioma	Venous Hemangioma
Mass lesion	Microscopic, incidental lesion	Mass lesion	Mass lesion
Diffuse, infiltrating	Localized	Localized	Localized
Cavernous	Predominantly capillary	Usually cavernous	Cavernous

Complete excision and examination is required for the diagnosis of any benign vascular lesion in the breast

Clinical

• May recur
• Rare lesion
  • Three adults, one child (male) and one infant reported
• Forms a mass lesion
• No metastases reported

Grading / Staging / Report

Grading / Staging

• Not applicable

Report

• If the diagnosis of a benign vascular lesion is made on a partial excision, it must be stated to be contingent upon complete excision

Lists

Breast Tumors with Vascular (and Pseudovascular) Differentiation

• Angiomatosis
• Angiosarcoma
• Hemangioma
• Perilobular Hemangioma
• Post-irradiation Atypical Vascular Lesion (skin of breast)
• Venous Hemangioma
• (Pseudoangiomatous stromal hyperplasia)

Bibliography

• Rosen PP, Oberman HA. Tumors of the Mammary Gland, Atlas of Tumor Pathology, AFIP Third Series, Fascicle 7, 1993
• Rosen PP. Vascular tumors of the breast. III. Angiomatosis. Am J Surg Pathol. 1985 Sep;9(9):652-8.
• Morrow M, Berger D, Thelmo W. Diffuse cystic angiomatosis of the breast. Cancer. 1988 Dec 1;62(11):2392-6.