Calcifications
and the Therapeutically
HERMAN
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Mammograms
of
81
I. LIBSHITZ,’
patients
who
ELEANOR
received
D. MONTAGUE,2AND
radiation
therapy to the breast were analyzed for patterns of preand postirradiation calcifications. Malignant calcifications may remain stable, diminish, or completely disappear following irradiation. The persistence of calcifications need not indicate residual cancer. Calcifications can develop following irradiation which are similar to either intraductal or secretory calcifications. Unusual calcifications may develop at the site of an irradiated cancer. It is important to recognize that benign calcifications can develop so that they will not be confused with recurrent malignancy.
Clinical
patients
should
who
be an effective
have
received
carcinoma of the breast. able on the appearance therapy.
Little
fications
in the
breast,
the
possible
regarding cations malignant
after
therapeutic
Records Institute
about nor
the
however, following
fate
is much
of malignant
development
irradiation. calcifications
This and
following
of
benign
radiation
Materials
and
Methods
received
at M. D. Anderson radiation
Hospital
therapy
to the
up
who
data
were
included.
therapy
Of
following
underwent
therapy
biopsy.
The
the
81
excision
following
average
age
met
biopsy
either
for
the
and Tumor
breast
mammograms had complete
ional
for
both clinical
these
carci-
before follow-
criteria,
35
(tumorectomy)
needle
biopsy
groups
was
two
and
or incis51
and
55
in
the
respectively.
Malignant
calcifications
were
seen
in
12
patients
needle/incision group. The appearance of the calcifications following irradiation was noted. Benign calcifications developed in four patients who underwent tumorectomy and in seven of the needle/incision biopsy group. Three patients with malignant
for
calci-
calcifications
available
report describes the development
D. PAULUS’
noma were reviewed. Those with and after radiation therapy and who
46
are availradiation
information
DAVID
of all patients who
received
of following irradiation
Few reports, of the breast
is known
calcifications
method
Breast
Material
years. Mammography
Irradiated
elsewhere
subsequently in the
treated
developed
benign
calcifications
breast.
calcifiMethod
changes in of benign
The types.
therapy.
of Treatment radiation
therapy
regimens
can
be
divided
into
three
1’ S
“a
I
-
S
.s
k
-
,
.1. 4-
.
‘ ..
.,
F
.B. i
a
4
$
-a ‘ . ,
a .‘.
4
‘
.
,
Fig.
(7,100
1.-A.
2
Am
Enlarged
rad) showing
Received 77030.
-4
.-
A
craniocaudad
disappearance
December
13, 1976;
Department
of Diagnostic
Address Department
reprint requests of Radiotherapy,
J Roentgenol
128:1021-1025,
view
of mass
accepted
Radiology.
of
breast
and decrease
after
revision
University
to H. I. Libshitz. University of Texas June
showing
1977
-;.i
cancer in malignant
March
,,f,:
with associated calcifications.
malignant
S
B, Same
calcifications.
breast
19 months
after
therapy
7. 1977.
of Texas System System
-a, -S
c.
Cancer
Cancer
Center.
Center,
M.
1021
M. D Anderson
D. Anderson
Hospital
Hospital and
and
Tumor
Tumor
Institute.
Institute.
Houston,
Houston.
Texas
Texas
77030
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1022
LIBSHITZ
El
AL.
.J,’.
.-
01.4
,m-
.
a,
I.,
L4,
‘1
,
ir
.B 2
.vith
A, Enlarged
-
‘malignant showing
-rad)
craniocudad
patients
were
malignant
of left
bret
breast,.
showing
17 months
calcificati#{244}’ns
‘treated:o!
nodal
me’nt
ofradial’and
consisted
: received and
after
andsizeof
cinically
breast
60Co
(8.400
Two
44
rounded
months
after,
alcifications
Note ‘
.
-
primary
ioperabI&’The
protracted
was
were
LSflourouracil
treat
iradiation
with
a
.!
therapy ,consisted
.
-
through i
;,
neutrons!to,the
-‘p
breast.
inflammatory
carci-
.5 :.
observation of. ytherna. peau Four of these patients had either in
combination
with
adriamycin
cr
1
a-
..
pp,aentrecIved,.4OO,
rad
.
,
. .
. ,-
inseven ‘
iai,tumoLclose
had
cIunucallyopefable and
tumorwere
excised ..
-f
grave
and followed
Irr#{227}diationwas ..
radA’in.5
bfollowed by reduced fields !fan#{225}dditionIL1.OOO_1.2SO
I
_.
plus
5 cm
without
plus
.:
fields
patients
5.000
tumor.doe
“L
reduced
less than
coerving’thebreast.
delivering.
..
oxygen?conditionS
classical
t#{243}tal