== Clinical Summary ==
This 56-year-old female was diagnosed with breast cancer and underwent a lumpectomy followed by radiation therapy. After 5 years without problems, the patient developed decreased exercise tolerance, dyspnea on exertion, shortness of breath, and an unintentional 15 pound weight loss. Recurrence of the breast cancer was identified but the patient opted for palliative therapy and subsequently expired at home.
This 60-year-old white female had developed retraction of her left nipple six years earlier, at which time breast At autopsy there was metastatic carcinoma was found. A radical mastectomy was performed. Examination of the surgical specimens showed metastases in regional lymph nodes and local irradiation was thus administered. Two years later, carcinoma of the right breast was found. Following a modified mastectomy, more irradiation was given. A year later the patient developed recurrences for which chemotherapy (cytoxan and adriamycin) was given. After a two year period without problems, the patient developed decreased exercise tolerancepericardium, dyspnea on exertionchest wall, shortness of breathdiaphragm, paroxysmal nocturnal dyspneaboth lungs, and orthopnea increasing in severity over 10 daysmediastinal lymph nodes. Chest examination revealed decreased breath sounds Areas of pleural thickening with dullness over adhesions and interstitial fibrosis were found involving the left base. Chest x-ray showed a globose cardiac silhouette and left pleural effusion. A pericardiectomy was done because anterior aspect of suspected cardiac tamponade; however, the patient died soon after the operationboth lungs.
== Autopsy Findings ==
