Breast cancer

Abstract

Radiation is an integral component of the treatment of early-stage breast cancer. Acute radiation dermatitis is common in these patients and can include erythema, dry desquamation, moist desquamation, and breast edema. Patient-related factors that have been associated with increased acute reactions include higher body mass index, larger bra cup size, smoking, and African-American ethnicity. Treatment-related factors that have been associated with increased acute reactions include the use and frequency of bolus, as well as concurrent use of tamoxifen, aromatase inhibitors, and chemotherapy. Late effects from radiation include recall dermatitis, telangiectasia, morphea, and fibrosis. Preventive measures for acute radiation dermatitis include the use of topical agents. Examples of these products and agents are moisturizers and emollients, topical steroids, skin barriers, and silicone dressings. Treatment of moist desquamation includes topical agents such as zinc and bacitracin; dressings such as Telfa, soft absorbent silicone (Mepilex Lite or Mepilex), and Aquacel Ag; as well as cleansers such as Hibiclens and Skintegrity. Treatment recommendations, week by week, to address erythema, dry desquamation, moist desquamation, candidiasis, cellulitis, folliculitis, and hyperpigmentation are presented.