To assess the fitness to work certificate in employees both affected by neoplasia and exposed to ionizing radiation always represents a clinical and professional issue, as well as human and social. The aim of our study is to analyze the case of a 40-year-old clinician (woman, endoscopist, gastroenterologist) who underwent left mastectomy and breast reconstruction with a tissue expander, professionally exposed to ionizing radiation. Due to the presence of the BRCA1 gene mutation and the presence of breast and ovarian cancer familiarity, the patient also underwent a prophylactic right mastectomy and bilateral oophorectomy. According to Italian legislation and international guidelines, several elements and criteria have been taken into account to release the fitness to work certificate in this peculiar case of a female worker exposed to ionizing radiation, resulting in a final positive indication
