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Interstitial brachytherapy technique for chest wall refractory recurrence of breast cancer.

Wu N, Chen Q, Zhao Z, Zhao H, Cheng G - J Contemp Brachytherapy (2015)

Bottom Line: This 44-year-old female presented with chest wall recurrence seven years after modified radical mastectomy for stage II breast cancer.Despite external beam radiation and chemotherapy, the lesion expanded as 5.3 × 5.1 × 3.0 cm(3), and 8.0 × 5.1 × 4.0 cm(3).Removal of the recurrent tumor was securely achieved by interstitial brachytherapy guided with ultrasound scanning.

View Article: PubMed Central - PubMed

Affiliation: These two authors contributed equally to this work.

ABSTRACT

Purpose: To report the treatment effect of interstitial brachytherapy for chest wall locoregional recurrence of breast cancer.

Material and methods: This 44-year-old female presented with chest wall recurrence seven years after modified radical mastectomy for stage II breast cancer. Despite external beam radiation and chemotherapy, the lesion expanded as 5.3 × 5.1 × 3.0 cm(3), and 8.0 × 5.1 × 4.0 cm(3). The locoregional recurrent tumor was treated with interstitial brachytherapy under ultrasound guidance. The brachytherapy dose was 30 Gy in 6 fractions of 5 Gy each.

Results: Removal of the recurrent tumor was securely achieved by interstitial brachytherapy guided with ultrasound scanning. The refractory tumor in patient healed uneventfully after interstitial brachytherapy without recurrence during the 7 months of follow-up.

Conclusions: The ultrasound-guided interstitial brachytherapy may be effective for refractory recurrence of breast cancer.

No MeSH data available.


Related in: MedlinePlus

Recurrent tumor on the skin surface of right chest wall
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Figure 0001: Recurrent tumor on the skin surface of right chest wall

Mentions: The case of a 44-year-old female with chest wall recurrence of breast cancer after initial surgery and radiochemotherapy is presented. Seven years before admitting to our clinic, she visited a vicinity clinic with a lump (2.4 × 2.2 × 3.0 cm3) located in the upper-outer quadrant of her right breast. She was diagnosed with breast cancer (T2N1M0; IIB stage) and received modified radical mastectomy; pathological result revealed medullary carcinoma and positive for ER, PR, and CerbB-2 expressions. The Ki-67 index was 30% based on the proportion of positively-stained tumor cells. Adjuvant chemotherapy with AC (adriamycin + cyclophosphamide) × 4 followed by T (paclitaxel) × 3, and hormonal therapy with tamoxifen were immediately started. The patient underwent initial radiotherapy by external beam: a total of 50 Gy in 2 Gy fractions for the chest wall and supraclavicular field. She had an abnormal CT scan revealing an area of distortion of approximately 3.0 × 3.0 × 2.3 cm3 in size on the skin surface of right chest wall, which was biopsied, and fine-needle aspiration was positive for malignant tumor (originate from breast) dating back to 18 months ago. The proposal of surgery was rejected by patient. She received 3 cycles of chemotherapy with GP (gemcitabine + cisplatin) and chose to undergo external radiotherapy to the recurrent tumor area with dosage of 60 Gy in 2 Gy per fraction. After radiochemotherapy, the obvious reduction of recurrent tumor size was detected. One year later, the patient noticed an augmentation of the mass on her right chest wall. The recurrent tumor was composed with two irregular masses (5.3 × 5.1 × 3.0 cm3, and 8.0 × 5.1 × 4.0 cm3) according to the CT scan (see Figure 1). She was referred to our clinic for treatment and requested brachytherapy instead because of the serious skin fibrosis in right chest wall.


Interstitial brachytherapy technique for chest wall refractory recurrence of breast cancer.

Wu N, Chen Q, Zhao Z, Zhao H, Cheng G - J Contemp Brachytherapy (2015)

Recurrent tumor on the skin surface of right chest wall
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4643729&req=5

Figure 0001: Recurrent tumor on the skin surface of right chest wall
Mentions: The case of a 44-year-old female with chest wall recurrence of breast cancer after initial surgery and radiochemotherapy is presented. Seven years before admitting to our clinic, she visited a vicinity clinic with a lump (2.4 × 2.2 × 3.0 cm3) located in the upper-outer quadrant of her right breast. She was diagnosed with breast cancer (T2N1M0; IIB stage) and received modified radical mastectomy; pathological result revealed medullary carcinoma and positive for ER, PR, and CerbB-2 expressions. The Ki-67 index was 30% based on the proportion of positively-stained tumor cells. Adjuvant chemotherapy with AC (adriamycin + cyclophosphamide) × 4 followed by T (paclitaxel) × 3, and hormonal therapy with tamoxifen were immediately started. The patient underwent initial radiotherapy by external beam: a total of 50 Gy in 2 Gy fractions for the chest wall and supraclavicular field. She had an abnormal CT scan revealing an area of distortion of approximately 3.0 × 3.0 × 2.3 cm3 in size on the skin surface of right chest wall, which was biopsied, and fine-needle aspiration was positive for malignant tumor (originate from breast) dating back to 18 months ago. The proposal of surgery was rejected by patient. She received 3 cycles of chemotherapy with GP (gemcitabine + cisplatin) and chose to undergo external radiotherapy to the recurrent tumor area with dosage of 60 Gy in 2 Gy per fraction. After radiochemotherapy, the obvious reduction of recurrent tumor size was detected. One year later, the patient noticed an augmentation of the mass on her right chest wall. The recurrent tumor was composed with two irregular masses (5.3 × 5.1 × 3.0 cm3, and 8.0 × 5.1 × 4.0 cm3) according to the CT scan (see Figure 1). She was referred to our clinic for treatment and requested brachytherapy instead because of the serious skin fibrosis in right chest wall.

Bottom Line: This 44-year-old female presented with chest wall recurrence seven years after modified radical mastectomy for stage II breast cancer.Despite external beam radiation and chemotherapy, the lesion expanded as 5.3 × 5.1 × 3.0 cm(3), and 8.0 × 5.1 × 4.0 cm(3).Removal of the recurrent tumor was securely achieved by interstitial brachytherapy guided with ultrasound scanning.

View Article: PubMed Central - PubMed

Affiliation: These two authors contributed equally to this work.

ABSTRACT

Purpose: To report the treatment effect of interstitial brachytherapy for chest wall locoregional recurrence of breast cancer.

Material and methods: This 44-year-old female presented with chest wall recurrence seven years after modified radical mastectomy for stage II breast cancer. Despite external beam radiation and chemotherapy, the lesion expanded as 5.3 × 5.1 × 3.0 cm(3), and 8.0 × 5.1 × 4.0 cm(3). The locoregional recurrent tumor was treated with interstitial brachytherapy under ultrasound guidance. The brachytherapy dose was 30 Gy in 6 fractions of 5 Gy each.

Results: Removal of the recurrent tumor was securely achieved by interstitial brachytherapy guided with ultrasound scanning. The refractory tumor in patient healed uneventfully after interstitial brachytherapy without recurrence during the 7 months of follow-up.

Conclusions: The ultrasound-guided interstitial brachytherapy may be effective for refractory recurrence of breast cancer.

No MeSH data available.


Related in: MedlinePlus