172 Radiotherapy marks Instruction Look at this patient’s chest. Patient 1 Salient features History • History of breast cancer • Ask about chemotherapy and schedule of radiotherapy. Examination • Telangiectasia over the chest wall • There may be a unilateral mastectomy. Diagnosis This patient has telangiectasia and a unilateral mastectomy (lesion), indicating that she has had radiotherapy (aetiology) for breast cancer in the past. Patient 2 Salient features Examination • India-ink marks over the chest (Fig. 172.1) • Localized erythema in the same region. Fig. 172.1 Radiation therapy marks. Diagnosis This patient has India-ink marks over the chest with localized erythema (lesion) indicating that she is currently undergoing radiotherapy treatment (aetiology). Advanced-level questions Which other normal tissues, apart from the skin, are affected by radiation therapy? Tissues that exhibit early or late damage from radiation therapy include mucosa, spinal cord, bone marrow and lymphoid system. To minimize these effects, radiation is normally delivered in a fractionated manner allowing recovery of normal host tissues (but not of tumour). The most serious potential late complications of radiation therapy to the breast are injury to the lungs and heart and the risk of inducing secondary cancers, such as sarcoma, lung cancer and contralateral breast cancer. Early studies of radiation therapy in patients with breast cancer demonstrated that inclusion of the LV in the high-dose region increased the long-term risk of death from cardiovascular disease. Radiation treatments for breast cancer are now given from linear accelerators and typically use medial and lateral opposed tangential fields that obliquely cross the anterior chest wall. CT planning of therapy ensures that the heart is outside the radiation field and the included lung volume is minimal. Only gold members can continue reading. Log In or Register to continue Share this:Click to share on Twitter (Opens in new window)Click to share on Facebook (Opens in new window)Like this:Like Loading... Related Related posts: Permanent cardiac pacemaker/implantable cardioverter-defibrillator Cauda equina syndrome Dermatomyositis Arteriovenous fistula Stay updated, free articles. Join our Telegram channel Join Tags: 250 Cases in Clinical Medicine Dec 4, 2016 | Posted by admin in GENERAL & FAMILY MEDICINE | Comments Off on Radiotherapy marks Full access? Get Clinical Tree
172 Radiotherapy marks Instruction Look at this patient’s chest. Patient 1 Salient features History • History of breast cancer • Ask about chemotherapy and schedule of radiotherapy. Examination • Telangiectasia over the chest wall • There may be a unilateral mastectomy. Diagnosis This patient has telangiectasia and a unilateral mastectomy (lesion), indicating that she has had radiotherapy (aetiology) for breast cancer in the past. Patient 2 Salient features Examination • India-ink marks over the chest (Fig. 172.1) • Localized erythema in the same region. Fig. 172.1 Radiation therapy marks. Diagnosis This patient has India-ink marks over the chest with localized erythema (lesion) indicating that she is currently undergoing radiotherapy treatment (aetiology). Advanced-level questions Which other normal tissues, apart from the skin, are affected by radiation therapy? Tissues that exhibit early or late damage from radiation therapy include mucosa, spinal cord, bone marrow and lymphoid system. To minimize these effects, radiation is normally delivered in a fractionated manner allowing recovery of normal host tissues (but not of tumour). The most serious potential late complications of radiation therapy to the breast are injury to the lungs and heart and the risk of inducing secondary cancers, such as sarcoma, lung cancer and contralateral breast cancer. Early studies of radiation therapy in patients with breast cancer demonstrated that inclusion of the LV in the high-dose region increased the long-term risk of death from cardiovascular disease. Radiation treatments for breast cancer are now given from linear accelerators and typically use medial and lateral opposed tangential fields that obliquely cross the anterior chest wall. CT planning of therapy ensures that the heart is outside the radiation field and the included lung volume is minimal. Only gold members can continue reading. Log In or Register to continue Share this:Click to share on Twitter (Opens in new window)Click to share on Facebook (Opens in new window)Like this:Like Loading... Related Related posts: Permanent cardiac pacemaker/implantable cardioverter-defibrillator Cauda equina syndrome Dermatomyositis Arteriovenous fistula Stay updated, free articles. Join our Telegram channel Join Tags: 250 Cases in Clinical Medicine Dec 4, 2016 | Posted by admin in GENERAL & FAMILY MEDICINE | Comments Off on Radiotherapy marks Full access? Get Clinical Tree