Thoracic manifestations of breast cancer and its therapy

Radiographics. 2004 Sep-Oct;24(5):1269-85. doi: 10.1148/rg.245035062.


Breast cancer is the second most common cause of cancer-related death in women. In most patients, imaging demonstrates thoracic changes resulting from either treatment, complications of treatment, or tumor recurrence or metastasis. The postsurgical imaging appearance of the chest wall depends on the surgical method used (radical mastectomy, modified radical mastectomy, breast-conserving surgery, breast reconstruction). The most common surgery-related complication is seroma. Radiation therapy frequently causes radiation pneumonitis, which occurs approximately 4-12 weeks after the completion of therapy and is characteristically limited to the field of irradiation. Chemotherapy-related complications include cardiotoxicity, pneumonitis, and infection. Ultrasonography and computed tomography are more sensitive than physical examination for detecting local and regional recurrence. The thorax is a common site of metastasis, which may affect the lymph nodes, bone, lung, pleura, or heart and pericardium. Bone metastasis is usually evaluated with bone scintigraphy and may cause spinal cord compression, a serious complication that requires early diagnosis. Intrapulmonary metastasis may manifest as single or multiple pulmonary nodules, airspace pattern metastasis, lymphangitic metastasis, or endobronchial metastasis. Pleural metastasis usually manifests as pleural effusion, with or without a pleural mass. Familiarity with the spectrum of radiologic findings in breast cancer patients allows accurate image interpretation and correct diagnosis.

Publication types

  • Review

MeSH terms

  • Adult
  • Aged
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Artifacts
  • Breast Neoplasms / complications*
  • Breast Neoplasms / drug therapy
  • Breast Neoplasms / radiotherapy
  • Breast Neoplasms / surgery
  • Female
  • Heart Neoplasms / diagnostic imaging
  • Heart Neoplasms / secondary
  • Humans
  • Lung Neoplasms / diagnostic imaging
  • Lung Neoplasms / secondary
  • Lymphatic Metastasis / diagnostic imaging
  • Mammaplasty
  • Mastectomy / adverse effects
  • Mastectomy / methods
  • Middle Aged
  • Neoplasm Recurrence, Local / diagnostic imaging
  • Pleural Effusion, Malignant / diagnostic imaging
  • Pleural Effusion, Malignant / etiology
  • Pneumonia / chemically induced
  • Pneumonia / diagnostic imaging
  • Postoperative Complications / diagnostic imaging
  • Postoperative Complications / etiology
  • Radiation Injuries / diagnostic imaging
  • Radiotherapy / adverse effects
  • Seroma / diagnostic imaging
  • Spinal Cord Compression / diagnostic imaging
  • Spinal Cord Compression / etiology
  • Spinal Neoplasms / diagnostic imaging
  • Spinal Neoplasms / secondary
  • Thoracic Diseases / diagnostic imaging*
  • Thoracic Diseases / etiology
  • Thoracic Neoplasms / diagnostic imaging
  • Thoracic Neoplasms / secondary
  • Tomography, X-Ray Computed