1/2. Morphea of the breast. Two case reports and discussion of the literature.Morphea, or localised scleroderma, is characterised by excess collagen deposition by lesional fibroblasts. This results in thickening and induration of the skin and subcutaneous tissues, often causing considerable morbidity. radiation-induced morphea was mentioned as early as the 1900s, but since then awareness of this condition has declined. The incidence of radiation-induced morphea is said to be two in 1000. Extension of the morphea beyond the radiation ports occurs in approximately one quarter of cases. No proven effective treatments exist, and to our knowledge, surgical excision has not been attempted. CASE PRESENTATIONS: We present two cases of morphea of the breast. The first patient developed progressive morphea in the absence of any causative factors. This was treated by Wise pattern breast reduction, incorporating the morphea within the excised skin. The second patient developed morphea following a course of radiotherapy for breast carcinoma. She has declined any surgical intervention, but suffers from considerable morbidity. Morphea is a recognised sequelae of radiotherapy which should be distinguished from sclerotic recurrence of the original tumour. Surgical excision is possible in certain patients.- - - - - - - - - - ranking = 1keywords = radiation-induced (Clic here for more details about this article) |
2/2. Hyperbaric oxygen treatment for symptomatic breast edema after radiation therapy.A 54-yr-old woman with a pT2pN0 breast cancer developed a long-standing symptomatic breast edema after lumpectomy and radiation therapy. The breast edema did not respond to non-steroidal anti-inflammatory drugs (NSAIDs) and manual lymph drainage of her arm. Three years after completion of radiation therapy, hyperbaric oxygen (HBO2) treatment was initiated. Fifteen HBO2 sessions were performed at a pressure of 240 kPa over 90 min in a multiplace chamber. At the end of treatment, breast discomfort had subsided completely, and 5 mo. after completing HBO2 therapy the patient is still free of complaints. We conclude from this observation that the value of HBO2 in the management of symptomatic radiation-induced breast edema should be investigated in a clinical study, because other effective treatment options are not available for this condition.- - - - - - - - - - ranking = 1keywords = radiation-induced (Clic here for more details about this article) |