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.
Highlights
The assessment of the long-term effects of breast irradiation is justified by the frequency of breast neoplasias, the role of radiotherapy in their locoregional management, and the importance of aesthetic outcomes
Case report Our work reports the case of a premenopausal 46-year-old patient, house wife, with no relevant personal medical history, sixth gesture fourth barrier, treated for a right breast neoplasia classified as T2 N1 M0
Histology substantiated the presence of an infiltrating ductal carcinoma SBR I of 2.8 cm 5N +/13
Summary
The assessment of the long-term effects of breast irradiation is justified by the frequency of breast neoplasias, the role of radiotherapy in their locoregional management, and the importance of aesthetic outcomes All of these factors are used in the assessment of the quality of care, especially after conservative treatment. The subsequent course was marked by the appearance of cutaneous sclerosis affecting the right upper limb nerve root in April 2021 (Figure 1; 13 months after the end of irradiation), significant lymphedema and clavicle fracture. This was confirmed by X-ray (Figure 2), with the site causing total function impotence and permanent pain of the right upper limb. The patient underwent physiotherapy sessions with slight improvement on the functional level and clear improvement on the sensory level with progressive disappearance of pain
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