Introduction Postradiation cutaneous angiosarcoma of the breast (PRCA) is very rare malignancy with an incidence ranged from 0.09 to 0.16%. It usually occurs after adjuvant radiotherapy following the treatment of breast cancer. In article published in August 2019 found about 50 cases of PRCA, the first case was published in 1948.

Case Report A 40-year-old woman was referred for a palpable right breast mass. She denied history of breast masses or issues.

Physical examination revealed a palpable right breast mass located at upper-outer right breast quadrant.

There were no other palpable breast masses, no palpable axillary, supra-clavicular, or infra-clavicular lymph nodes.The patient underwent a right breast core biopsy of the mass the pathology of the biopsy revealed invasive ductal carcinoma. She underwent a right lumpectomy with a right axillar lymph node dissection.

There was no metastatic lymph node. the patient underwent standard external radiotherapy (50 gy to the whole breast and 16 gy as a boost to the tumor bed) and chemotherapy then hormonotherapy by tamoxifen.

She was followed with clinical and radiological surveillance. Seven years after the surgery she was presented with erythematous plaque associate with multiple purplish nodules, the mammography and the ultrasound was normal, the patient underwent a biopsy, the histlogical examination showed a post radiation cutaneous angiosarcoma.

Conclusion The PRCA is rare and aggressive disease, the diagnostic is clinically difficult and often missed on mammography, usually the biopsy confirm the diagnostic.