title: Simultaneous osteonecrosis and osteomyelitis in a patient with cancer of the breast.
abstract: Breast cancer is generally managed surgically with adjuvant agents which include hormone therapy, chemotherapy, radiotherapy and bisphosphonate therapy. However, some of these adjuvant therapies may cause adverse events, including wound infection, neutropenia, bone marrow suppression and fever. The simultaneous presentation of osteonecrosis and osteomyelitis has not previously been described in patients with breast cancer undergoing hormone therapy and chemotherapy. We report a patient with breast cancer who developed bone infarcts in both legs as well as osteomyelitis in the right distal tibia after treatment which included a modified radical mastectomy, hormone therapy and chemotherapy. Simultaneous osteonecrosis and osteomyelitis should be considered in patients with breast cancer who are receiving chemotherapy and hormone therapy who present with severe bone pain, especially if there have been infective episodes during treatment.
authors.affiliation: Department of Orthopaedics and Institute of Clinical Medicine, College of Medicine, National Cheng Kung University Hospital, Tainan, Taiwan No. 138 Sheng Li Road,Tainan City 70428, Taiwan.
authors.forename: K-Y
authors.initials: KY
authors.lastname: Huang
authors.forename: R-S
authors.initials: RS
authors.lastname: Yang
authors.forename: C-C
authors.initials: CC
authors.lastname: Hsieh
mesh_terms: D000328:Adult; D000970:Antineoplastic Agents / Q000009:adverse effects; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use; D001859:Bone Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary*; D001943:Breast Neoplasms / Q000628:therapy*; D018270:Carcinoma, Ductal, Breast / Q000628:therapy*; D005260:Female; D006801:Humans; D010019:Osteomyelitis / Q000139:chemically induced* / Q000000981:diagnostic imaging; D010020:Osteonecrosis / Q000139:chemically induced* / Q000000981:diagnostic imaging; D011859:Radiography
chemical_list: D000970:Antineoplastic Agents