Radiation-induced breast changes

Radiation-induced breast changes are a consequence of radiotherapy toxicity over the breast tissues either related to targeted breast cancer treatment or other thoracic malignancies (eg. lung cancer).

Radiographic features

The radiation-induced breast changes may be seen in either dedicated breast imaging or CT chest performed for follow-up of other thoracic malignancies.

• skin thickening
  • commonly seen within 6 months of the completion date
  • slowly resolve until a certain point where a fibrotic thickening may persist
• interstitial edema
  • diffuse trabecular thickening representing engorged lymphatics
• oil cysts/fat necrosis
• dystrophic calcifications
• focal skin retraction
• glandular atrophy
  • asymmetry of the glandular parenchyma noted when compared to contralateral breast
  • decreased breast size
• breast fibrosis
• radiation-induced breast cancer

Treatment and complications

Radiation-induced breast malignancy is rare and possible induced tumors include:

• invasive ductal carcinoma
• angiosarcoma

Differential diagnosis

Differential diagnosis is mainly considered in those patients treating breast cancer, as it may be difficult to distinguish the above-mentioned breast changes from:

• local breast recurrence
• inflammatory breast cancer
• breast infection