Primary low-grade breast angiosarcoma initially misdiagnosed as a benign vascular lesion

Primary breast angiosarcoma is an exceptionally rare malignancy, particularly in elderly patients, and may closely resemble benign vascular lesions on imaging and core needle biopsy. We report a case of low-grade primary angiosarcoma in a woman in her late 70s, initially misdiagnosed as a haemangioma despite interval tumour growth. A definitive diagnosis was achieved only after wide local excision, which demonstrated well to intermediately differentiated angiosarcoma with clear margins. Given the limited evidence supporting adjuvant therapy in low-grade disease, surgery alone was appropriate, and the patient remains recurrence-free at 2.5 years. This case highlights the diagnostic challenges and importance of maintaining suspicion in older adults.