Squamous cell carcinoma of the thoracic esophagus following radiation therapy for breast cancer

Between 1981 and 1995, 4 patients (3 females, 1 male; aged 48-80) were diag nosed with squamous cell carcinoma of the esophagus, following mediastinal irradiation for breast cancer. The interval between irradiation and the pre sentation of esophagal cancer was 10.75 years on average (7-19). The treatm ent consisted of: radiotherapy only; a partial esophagectomy with proximal gastrectomy without post-operative radiotherapy; laser photocoagulation for a superficial tumor; and, palliative treatment including gastrostomy, trac heal photocoagulation and chemotherapy for 1 patient suffering from advance d stage cancer with tracheal invasion, respectively. Radiotherapy of the es ophagal cancer (exclusive or adjuvant) should take into account previous es ophageal radiation therapy. The indications of curative excision surgery ar e the same as for other types of esophageal cancer, but the anastomoses sho uld be performed in a non-irradiated area. Excision by esophageal stripping without thoracotomy is contraindicated because of the presence of peri-eso phageal sclerosis. Preventive measures in radiation therapy for breast canc er are suggested.