Donnell et al listed histologic features that can be used to grade angiosarcomas of the breast. The authors are from Memorial Sloan-Kettering Cancer Center in New York City and the Medical College of Virginia.
Features common to all grades:
(1) involvement of breast parenchyma
(2) interanastomosing vascular channels
(3) hyperchromatic endothelial cells
Features useful for grading:
(1) endothelial tufting
(2) papillary formations
(3) solid and spindle cell foci
(4) mitoses
(5) "blood lakes"
(6) tumor necrosis
Histologic Features
Low Grade
Intermediate Grade
High Grade
endothelial tufts
minimal
present
prominent
papillary areas
absent
focal
present
mitoses
absent or rare
present in papillary areas
numerous
solid and spindle cell foci
absent
absent or minimal
present
blood lakes
absent
absent
present
necrosis
absent
absent
present
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