Radiation-induced cutaneous vasculopathy of the breast: a rare case report

World J Surg Oncol. 2024 Feb 21;22(1):60. doi: 10.1186/s12957-024-03346-0.

Abstract

Background: Radiation therapy is often indicated as part of the treatment for breast cancer and is therefore used frequently worldwide. Vasculopathy is a general term used to describe any condition that affects blood vessels. We present a case report of a patient who presented with vasculopathy as a rare late side effect of radiation therapy to the breast.

Case presentation: This 66-year-old woman was initially treated with breast-conserving surgery for early-stage receptor-positive left breast carcinoma. She received postoperative radiation therapy and hormonal treatment with tamoxifen. She developed sudden spontaneous painless ecchymosis spread over the whole irradiated area 1.5 years after finishing her radiation therapy. Tumor relapse was excluded. There was no associated vasculitis. The cause was presumed to be multifactorial. She had a history of smoking and was known to have hyperlipidemia. She had undergone several surgical treatments at the left breast one year after her initial breast-conserving treatment and was taking tamoxifen. Anti-inflammatory medicine and treatments increasing local blood flow were prescribed. The ecchymosis resolved completely within one month.

Conclusions: Vasculopathy can occur as a rare late side effect of radiation therapy. It can be reversible. Prevention begins with carefully treating precipitating factors.

Keywords: Breast cancer; Ecchymosis; Late toxicity; Purpura; Radiation therapy; Vasculopathy.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Breast Neoplasms* / pathology
  • Ecchymosis / drug therapy
  • Ecchymosis / surgery
  • Female
  • Humans
  • Mastectomy, Segmental
  • Neoplasm Recurrence, Local / surgery
  • Tamoxifen / therapeutic use
  • Vascular Diseases* / surgery

Substances

  • Tamoxifen