A 42-year-old woman was diagnosed w

A 42-year-old woman was diagnosed with invasive ductal carcinoma of the right breast (T2-N1-MX), with estrogen, progesterone, and HER-2/neu receptors positive. Two of 10 axillary lymph nodes were positive. She was treated with lumpectomy, axillary node dissection, and adjuvant chemotherapy consisting of doxorubicin/cyclophosphamide. Therapy was discontinued after three cycles because she had developed local axillary and cutaneous recurrence. She was subsequently treated for 12 weeks with paclitaxel/trastuzumab on a clinical trial, underwent bilateral total mastectomies, and received 60 Gy of radiation to her right chest wall/axilla. She was evaluated 6 weeks after completion of radiotherapy. On examination she had normal vital signs and negative physical examination. Laboratory evaluation revealed alkaline phosphatase of 262 U/L (normal, 50 to 136 U/L), AST and ALT of 72 U/L and 92 U/L, respectively (normal, 3 to 48 U/L and 30 to 65 U/L). These were normal 4 months earlier. Abdominal computed tomography scan revealed an abnormal "straight-border"1—attenuation of the liver along the trajectory of radiation beam used previously—representing radiation-induced liver disease (RILD; Fig 1A, arrows).

A 42-year-old woman was diagnosed with invasive ductal carcinoma of the right breast (T2-N1-MX), with estrogen, progesterone, and HER-2 / neu receptors positive. Two of 10 axillary lymph nodes were positive. She was treated with lumpectomy, axillary node dissection, and adjuvant chemotherapy consisting of doxorubicin / cyclophosphamide. Therapy was discontinued after three cycles because she had developed local axillary and cutaneous recurrence. She was subsequently treated for 12 weeks with paclitaxel / trastuzumab on a clinical trial, underwent bilateral total mastectomies, and received 60 Gy of radiation to her right chest wall / axilla. She was evaluated 6 weeks after completion of radiotherapy. On examination she had normal vital signs and negative physical examination. Laboratory evaluation revealed alkaline phosphatase of 262 U / L (normal, 50 to 136 U / L), AST and ALT of 72 U / L and 92 U / L, respectively (normal, 3 to 48 U / L and 30 to 65 U. / L). These were normal 4 months earlier. Abdominal computed tomography scan revealed an abnormal "straight-border" 1-attenuation of the liver along the trajectory of radiation beam used previously-representing radiation-induced liver disease (RILD; Fig 1A, arrows).

A 42-year - old woman was diagnosed with invasive ductal carcinoma of the right breast (T2-N1-MX), with Estrogen Progesterone,,, And HER-2 / neu receptors positive. Two of 10 axillary lymph nodes were positive. She was treated, with lumpectomy axillary. Node dissection and adjuvant, chemotherapy consisting of doxorubicin / cyclophosphamide.Therapy was discontinued after three cycles because she had developed local axillary and cutaneous recurrence. She was. Subsequently treated for 12 weeks with paclitaxel / trastuzumab on a clinical trial underwent bilateral total mastectomies,,, And received 60 Gy of radiation to her right chest wall / axilla. She was evaluated 6 weeks after completion of radiotherapy.On examination she had normal vital signs and negative physical examination. Laboratory evaluation revealed alkaline phosphatase. Of 262 U / L (normal 50 to, 136 U / L), AST and ALT of 72 U / L and 92 U / L respectively (,, normal 3 to 48 U / L and 30 to 65 U / L).? These were normal 4 months earlier.Abdominal computed tomography scan revealed an abnormal "straight-border." 1 - attenuation of the liver along the trajectory. Of radiation beam used previously - representing radiation-induced liver disease (RILD; Fig, 1A arrows).