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Article
July 15, 1988

Massive Osteolysis of the Right Clavicle Developing After Radiation Therapy

Author Affiliations

From the Departments of Medical Oncology (Drs Skinner and Buzdar) and Diagnostic Radiology (Dr Libshitz), University of Texas M. D. Anderson Hospital and Tumor Institute at Houston.

From the Departments of Medical Oncology (Drs Skinner and Buzdar) and Diagnostic Radiology (Dr Libshitz), University of Texas M. D. Anderson Hospital and Tumor Institute at Houston.

JAMA. 1988;260(3):375-376. doi:10.1001/jama.1988.03410030091035
Abstract

History  A 52-year-old woman had a right modified radical mastectomy in February 1980 for a stage II, Tl (2-cm mass), N1 (three of 13 lymph nodes positive), MO, estrogen receptor-positive breast cancer. She received postoperative irradiation with 40 Gy delivered by opposing tangential fields to the chest wall and by a single anterior field to the supraclavicular and internal mammary areas; 10 Gy of additional radiation was also given to the posterior axilla. Adjuvant combination chemotherapy was given with six courses of fluorouracil, doxorubicin (Adriamycin), cyclophosphamide (Cytoxan), vincristine, and prednisone. The total doxorubicin dose was 300 mg/m2.2. After completion of adjuvant combination chemotherapy, 10 mg of tamoxifen twice a day was given for six months concomitantly with three months of methotrexate therapy followed by three months of vinblastine therapy.The patient sustained a fall in February 1981 and suffered a fracture of the medial aspect of her right

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