Late pulmonary metastasis of inflammatory breast cancer 26 years after initial radiation therapy alone

A 64-year-old woman underwent cobalt-60 radiation therapy 26 years ago because of advanced inflammatory breast cancer. The initial stage was T4N0M0. During the course of cobalt-60 therapy, the patient presented severe chest wall necrosis. Her chest wall wound healed very slowly and she decided to stop radiation therapy and declined both surgery as well as chemotherapy. After chronic wound healing, the patient did not come back for follow-up. Twenty-six years later, she came back for mild dyspnea. Subsequent study showed suspicious lung metastasis. Later, she underwent thoracoscopic biopsy, with which lung metastasis was confirmed. She recovered well and currently receives oral chemotherapy for disease control.