Dermatologic toxicities associated with radiation therapy in women with breast cancer

Abstract

Breast-conserving surgery with adjuvant radiation therapy has become the standard of care for women with early stage breast cancer, and as a result, a large number of patients are affected by the cutaneous sequelae of radiation therapy. These dermatologic toxicities may present during treatment or years later and can significantly impact patients' quality of life. In this review, we discuss the clinical presentation, prevention, and management of radiation-induced cutaneous toxicities in women with breast cancer, including radiation dermatitis, radiation recall, radiation-induced morphea, radiation-induced fibrosis, and cutaneous malignancies in irradiated skin.

Keywords: Breast cancer; Cutaneous toxicities; Oncodermatology; Radiation dermatitis; Radiation therapy; Radiation-induced morphea.

Fig. 1

(A) Acute radiation dermatitis manifesting as erythematous patches with dry desquamation weeks after radiation therapy for breast cancer. (B) Severe presentation of acute radiation dermatitis manifesting as moist desquamation.

Fig. 2

Radiation-induced morphea presenting as a round erythematous plaque with a violaceous border on the lateral breast.

Fig. 3

Radiation-induced fibrosis presenting as marked contracture and breast deformity. Note the surrounding chronic radiation changes, including dyspigmentation and telangiectasias.

Fig. 4

(A) Atypical vascular lesion presenting as a red papule on an irradiated chest. (B) Radiation-induced telangiectasias localized to the radiation field.