Radiation therapy is an established form of therapy for breast cancer, often applied in an adjuvant setting delivered in a post-operative environment to volumes including the breast, surgical cavity, and regional lymph nodes when appropriate. Historically, radiation therapy has not been considered an option for care when the patient recurs with the disease despite being treated with radiation therapy in the adjuvant setting. However, there can be clinical circumstances that require a different approach to the care including comprehensive re-treatment with radiation therapy in highly selected situations. This paper reviewed two patients with clinical circumstances requiring consideration for re-treatment with radiation therapy and were successfully re-treated with an acceptable outcome.

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Mucin is a hyaluronic acid complex found in modest quantity in dermal connectives tissues. It serves as a protective barrier and supports tissue elasticity. Mucin has an important role as a response vehicle to injury and trauma in multiple body regions. Although thought to be produced by connective tissue, fibroblasts, and mast cells, the origin and regulatory mechanisms associated with production and absorption of mucin are largely unknown. Accumulation of unregulated large volumes of mucin in subcutaneous tissues can result in pain and limited wound healing when tissues over saturated with mucin are injured. Repair systems are less effective in edematous tissue as cell systems required for healing cannot accumulate at the site of injury in an organized enterprise manner. Clinically relevant forms of mucinosis have been described in hypothyroidism, thyrotoxicosis, and scleromyxedema associated with monoclonal gammopathies. Mucinosis has also been associated with systemic lupus, systemic sclerosis, and dermatomyositis including patients treated with chemoradiotherapy.In this paper we present a case report of an individual who had exhausted traditional therapies for mucinosis associated with an underlying thyroid disorder and had significant difficulty walking due to pain and discomfort in both her feet and distal lower extremities. We report on successful application of radiation therapy to effectively treat her symptoms.

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