LAUSR

IntroductionTo report a case of radiation necrosis after reirradiation for breast cancer and the difficulties encountered when treating these complex cases.Patients and methodsWe present a 86-year-old woman with a history of right sided intraductal breast cancer treated with a right mastectomy followed by local adjuvant radiotherapy (50 Gray). Twelve years later, she was diagnosed with a local recurrence in the mastectomy scar which was treated with local resection (including resection of rib four) and adjuvant radiotherapy up to 32 Gray. In July 2020 she presents at the Department of Plastic and Reconstructive Surgery with a chronic ulcer on the right sided hemithorax.ResultsA multi-staged, multidisciplinary approach was necessary to secure lasting coverage of the extensive defect.ConclusionThoracic radiation necrosis should be subject to a multidisciplinary approach (plastic and thoracic surgeons) pre-, per- and postoperatively. Each case may require a different surgical approach depending on size and depth of the defect, patients' age, comorbidities and previous medical treatment.