Case Report: Late complications of radiotherapy for breast cancer

Abstract

The long term functional and aesthetic impact of breast neoplasia treatment partly reflects the consequences of high dose irradiation of the skin and subcutaneous tissue. This work, based on a case observed in our department and a review of the literature, aims to discuss certain secondary manifestations following breast irradiation and their therapeutic options. Our work reports the case of a premenopausal 46-year-old patient, treated for a right breast neoplasia. In July 2019, the patient underwent a Patey with simple postoperative follow-up. Histology substantiated the presence of an infiltrating ductal carcinoma SBRI. Mastectomy was followed by locoregional irradiation and adjuvant chemotherapy. Thirteen months after the end of irradiation, the patient reconsulted for functional impotence and pain at the level of the right upper limb. The clinical examination showed cutaneous sclerosis and lymphedema. An X-ray showing the non-metastatic fracture of the clavicle. The patient underwent physiotherapy sessions with slight improvement on the functional level and clear improvement on the sensory level with progressive disappearance of pain. Therapeutic options for complications of breast irradiation include massage, bandages, and physical exercise, often used in combination. The precise localization of the tumor bed and the application of appropriate clinical target volumes and planning target volumes are essential, as these concepts are fundamental for partial breast irradiation and avoid the complications of radiotherapy.