Post-radiation Bone Lesions in Mammary Cancer

Abstract

The radiographic patterns of post-radiation bone lesions in eight patients treated for breast cancer are described. Rib fractures - often multiple - at the anterior portion of the rib were observed in all patients. Two of them showed also lesions of the shoulder-blade, with a lesion in the humeral diaphysis in one. Only some of the eight patients have been heavily irradiated as far as the total dose, the diameter of the fields and the dose-time is concerned. In these cases the lesions were more severe and large in comparison to the other patients. Bone repair and reconstruction were not observed even after many years from initial treatment. Areas of overdosage at the level of bone structures may have occurred also in the other cases, where the usual therapeutical limits had not been overcome. This overdosage is likely to be due to the particular geometric relationships between neoplastic foci and thoracic wall, requiring several irradiation fields. From the radiographic point of view rib fractures are difficult to detect in their earlier phase; therefore the differential diagnosis has to be made with traumatic fractures. Later their recognition becomes easier though occasionally the problem of a differentiation from possible metastatic foci may arise.