Surgical Pathology Criteria–

Angiosarcoma of the Breast

Grading / Staging / Report

Grading

	Low Grade	Intermediate Grade	High Grade
Anastomosing channels	Prominent	Prominent	Frequently inconspicuous
Papillary growth	Rare to absent	Prominent	Variable
Endothelial tufting	Rare to absent	Prominent	Variable
Cytologic atypia	Mild	Mild to prominent	Prominent
Mitotic figures	Rare	Frequent	Frequent
Solid areas	Absent	Focal or absent	Prominent
Necrosis	Absent	Absent	Present
Blood lakes	Absent	Absent	Often present

Awareness of the varying patterns exhibited by the above grades is useful for diagnostic purposes but it is not clear that it has any predictive value

Staging

Evaluation of margins may be extremely difficult as peripheral neoplastic vessels may be cytologically and architecturally quite bland
Contralateral disease is generally evidence of metastasis rather than a second primary

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