Radiation-Induced Rib Fractures on Magnetic Resonance Imaging Following Proton Therapy for Breast Cancer With Pencil Beam Scanning

Ashley R Way; Paul L Wasserman; Raymond Mailhot; Haley Letter

doi:10.7759/cureus.11120

Radiation-Induced Rib Fractures on Magnetic Resonance Imaging Following Proton Therapy for Breast Cancer With Pencil Beam Scanning

Cureus. 2020 Oct 24;12(10):e11120. doi: 10.7759/cureus.11120.

Authors

Ashley R Way¹, Paul L Wasserman¹, Raymond Mailhot², Haley Letter¹

Affiliations

¹ Radiology, University of Florida Health Jacksonville, Jacksonville, USA.
² Radiation Oncology, University of Florida Health Jacksonville, Jacksonville, USA.

Abstract

Radiation-induced rib fractures (RIRF) are long-term complications associated with irradiation of the chest/chest wall. RIRFs are commonly seen in lung- or breast-cancer patients treated with stereotactic body radiotherapy (SBRT) or conventional external beam radiation therapy (EBRT), respectively. We report a case of a 31-year-old female presenting with pathological fractures of the third, fourth, and fifth ribs discovered on magnetic resonance imaging (MRI) as a complication from pencil beam scanning (PBS) proton therapy (PT), of the whole left breast and regional lymph nodes. To our knowledge, this presentation is the first to be initially reported on MRI in radiological literature.

Keywords: high risk breast cancer; locally advanced breast-cancer; pathological rib fracture; pencil beam scanning; proton therapy; radiation induced rib fracture; radiation induced skeletal injury.

Publication types

Case Reports