Post-irradiation Morphea of the breast: A case report and review of the literature

Abstract

We describe a 44-year-old female with triple negative breast cancer who 15 months after completion of post-lumpectomy chemotherapy and radiotherapy developed skin erythema, sclerosis and contracture of her entire right breast consistent with post-irradiation morphea (PIM). PIM is a rare complication of breast irradiation that impairs a patient's quality of life. PIM is usually located at the radiation port or in the surrounding tissue. PIM is commonly clinically misdiagnosed as lymphedema and cellulitis in the early inflammatory phase, and recurrent breast cancer, chronic radiodermatitis (CRD), radiation-induced fibrosis (RIF), post irradiation pseudosclerodermatous panniculitis (PIPP), atypical vascular lesions (AVL) or angiosarcoma (AS) in the late burnout phase. Arriving at the correct diagnosis typically requires a multidisciplinary approach, including a skin biopsy for confirmation. To date, satisfactory treatment of this condition has been challenging and the clinical outcome after therapy is often unsatisfactory.

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