A case of metachronous bilateral breast cancer with bilateral radiation pneumonitis after breast-conserving therapy
| Autor: | Hiroshi Kodama, Sachiko Kawamura, Yasushi Nagata, Norio Araki, Michihide Mitsumori, Seiji Tachiiri, Keiichi Mise, Masaru Narabayashi, Masahiro Hiraoka, Takashi Sakamoto, Natsuo Oya, Chikako Yamauchi |
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| Rok vydání: | 2006 |
| Předmět: |
medicine.medical_specialty
Axillary lymph nodes medicine.medical_treatment Breast Neoplasms Mastectomy Segmental Breast cancer Whole Breast Irradiation Antineoplastic Combined Chemotherapy Protocols Medicine Humans Pharmacology (medical) Radiology Nuclear Medicine and imaging skin and connective tissue diseases business.industry Cancer Partial Breast Irradiation General Medicine Middle Aged medicine.disease Combined Modality Therapy Surgery Radiation therapy Radiation Pneumonitis Tamoxifen medicine.anatomical_structure Oncology Axilla Female Radiography Thoracic Fluorouracil Lymph Nodes business Mastectomy medicine.drug |
| Zdroj: | Breast cancer (Tokyo, Japan). 13(3) |
| ISSN: | 1340-6868 |
| Popis: | We report a patient with metachronous bilateral breast cancer who has twice developed radiation pneumonitis after breast-conserving therapy for each breast. The patient was a 48-year-old woman, who presented with Stage I right breast cancer. After wide excision of the right breast tumor and dissection of level I axillary lymph nodes, systemic therapy with oral 5-FU and tamoxifen was started. Subsequently, tangential irradiation with a total dose of 50 Gy in 25 fractions was given. Seven months after irradiation, she developed respiratory symptoms and radiation pneumonitis was diagnosed. The symptoms resolved with oral prednisolone. Thirty months after the right breast cancer treatment, Stage I left breast cancer was diagnosed. After wide excision of the left breast tumor and partial removal of the level I axillary lymph nodes, the same oral systemic chemo-hormonal therapy was initiated. Thereafter, tangential irradiation with a total dose of 50 Gy in 25 fractions was given. Four months after irradiation, she developed respiratory symptoms. A chest X-ray showed an area of increased density in the left lung consistent with radiation pneumonitis. The symptoms were mild and they improved spontaneously without medication. Although there is insufficient evidence to justify or withhold whole breast radiation therapy from patients with a history of contralateral breast cancer and radiation pneumonitis, it is essential to discuss the adequacy of whole breast irradiation and the possibility of alternative approaches, such as breast-conserving surgery without irradiation or partial breast irradiation for this rare condition. |
| Databáze: | OpenAIRE |
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