case_images: PMC11308955_01
case_images: PETCT scan confirmed FDG-avid disease involving the left breast and regional lymph nodes (internal mammary and axilla) on both maximal intensity projection (A) and fused axial images at the level of the breast (B) and axilla (C). Clinical photograph (D) of the left breast mass prior to treatment.
case_images: ICRP_A_2389172_F0001_C.jpg
case_images: PMC11308955_01_ICRP_A_2389172_F0001_C.jpg
case_images: F0001
case_images: Fluorodeoxyglucose (FDG) avid lymph nodes were present at the left internal mammary (subcentimeter, SUV 12) and left axillary (2.5 cm, SUV 16) nodal basins, consistent with regional sites of disease (Figure 1).
case_images: PETCT scan after 3 cycles of BV-CHP confirming response to treatment within the left breast and lymph nodes on maximal intensity projection (A) and fused axial images at the level of the breast (B) and axilla (C). The lymphoma five point score was assigned as a 4, with uptake above the level of the liver.
case_images: ICRP_A_2389172_F0002_C.jpg
case_images: PMC11308955_01_ICRP_A_2389172_F0002_C.jpg
case_images: F0002
case_images: After 3 cycles, she had a significant positive response (Figure 2), and after 6 cycles, PET-CT confirmed a complete metabolic response to therapy (Figure 3).
case_images: PETCT scan after 6 cycles of BV-CHP confirming complete response to systemic therapy within the left breast and regional lymph nodes on maximal intensity projection (A) and fused axial images at the level of the breast (B) and axilla (C). the lymphoma five point score was assigned as a 3, indicating a complete metabolic response. Photograph (D) confirming an excellent clinical response to treatment with only hyperpigmentation and scar remaining.
case_images: ICRP_A_2389172_F0003_C.jpg
case_images: PMC11308955_01_ICRP_A_2389172_F0003_C.jpg
case_images: F0003
case_images: After 3 cycles, she had a significant positive response (Figure 2), and after 6 cycles, PET-CT confirmed a complete metabolic response to therapy (Figure 3).
case_images: PMC11308955_02
case_images: Axial representation of the patient's RT simulation scan in the free breathing (A) and deep inspiration breath hold (DIBH) (B) positions showing the benefit of increased distance between heart (pink) and breast as well as increased lung volume (blue) during DIBH.
case_images: ICRP_A_2389172_F0004_C.jpg
case_images: PMC11308955_02_ICRP_A_2389172_F0004_C.jpg
case_images: F0004
case_images: A deep inspiration breath hold technique was used to increase her lung volume and the distance between the left breast and her heart (Figure 4).
case_images: Axial representation of the patient's RT simulation scan with RT treatment plan at the level of the internal mammary and axillaryl lymph nodes (A) and left breast mass (B). the prescription radiation isodose line (2500 cGY) encompasses the intended targets while avoiding critical structures such as the heart and lungs.
case_images: ICRP_A_2389172_F0005_C.jpg
case_images: PMC11308955_02_ICRP_A_2389172_F0005_C.jpg
case_images: F0005
case_images: Due to time constraints, she was treated with a slightly hypofractionated radiation therapy course with 25 Gy given over ten fractions (Figure 5).