**9.3 Remodeling of a locally advanced breast cancer**

We present here the clinical situation of a local advanced breast cancer in women aged 82 who presented in our department and was treated by a conformal 10 fields of radiotherapy (**Figure 11**).

#### **Figure 11.**

*The clinical case of a local advanced breast cancer with sternal infiltration and internal mammary chain lymph node involvement before and after high dose radiotherapy. Upper line: Clinical response to a high total dose of 72 Gy. Lower line: (left) in the primary series a total dose of 50 Gy in 25 fractions and (right) an additional boost of 22 Gy in 2 Gy fractionation was applied.*

#### *Radiation Oncology*

This case demonstrates the "remodeling" ability that exists in healthy tissues surrounding the tumor bed. In this case, the healing action was completed by macrophages and fibroblasts present at this level. The action of fibroblasts has contributed to the collagen formation process to be present and to make possible "remodeling" at this level of all the structures initially involved: skin, ribs, pericardium, sternum, etc. Visible is the presence of an extensive area of collagen in the extensive scar.

In the healing process, the role of macrophages was the removal of damaged tumor cells by the double-strand lesion at the level of tumor DNA. There was no pulmonary fibrosis that usually accompanies post-radiotherapy healing [6].
