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Pulmonary changes after primary irradiationfor early breast carcinoma.

The clinical records and radiographs of 37 patients with carcinoma of the breast (stages I and II) treated with primary radiation therapy without mastectomy were reviewed. In 10 patients, there was a radiographic pattern of increased radiopacity in the lung underlying the treated breast. The margins of the lesion corresponded to those of the tangential radiation ports with a well defined posterior border noted on the lateral chest radiograph. Apical fibrosis (secondary to supraclavicular irradiation) was demonstrated in six other patients. No patient had symptoms referable to the radiation injury. With the increasing use of radiation therapy as initial treatment for early stage carcinoma of the breast, it is important to recognize these radiation changes in the lungs and distinguish them from infection or recurrent tumor.