An audit of radiation-induced skin reactions in the inframammary fold; does breast size impact on the severity of the reaction?

SOUTHWORTH, A., CLOUGH, H. and ROBERTS, Neill (2020). An audit of radiation-induced skin reactions in the inframammary fold; does breast size impact on the severity of the reaction? Radiography, 26 (3), 192-197.

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Introduction Skin toxicity is a clinically significant side effect of external beam radiation; moist desquamation is particularly prevalent for breast patients, mainly in the axilla and inframammary fold (IMF). The aim of this audit was to assess if there is a correlation between patient breast size and the presence and extent of radiotherapy skin reaction in the IMF. Methods Between 22/12/2017 and 31/05/2018 forty patients undergoing standard whole breast radiotherapy using 3D planned medial and lateral tangential fields had their skin reaction recorded weekly, whilst on treatment, using the Radiotherapy Oncology Group (RTOG) scoring system. Skin reactions were also documented at three and eight weeks post radiotherapy. A measurement of the patients IMF length and bra size were also noted. Statistical analysis was carried out using IBMÒ SPSS Statistics Results Six patients presented with grade ≥2 during week three of radiotherapy. The mean IMF length of six patients with adverse reactions 6.1 cm (±3.6 cm). As the length of the IMF increases, severity of skin reactions also increases; a positive correlation was identified between the two at both week three of radiotherapy and three weeks post radiotherapy (r = 0.401, n = 34, p = 0.05 and r = 0.671, n = 29, p = 0.00 respectively). Only one patient displayed grade 2 at eight weeks post radiotherapy (IMF length 7.5 cm). Conclusion The findings from this study would suggest that larger breasted patients do present earlier, and with more severe radiation-induced skin reactions. Implications for practice Changes to skin care practice could be considered for patients with larger breasts. This could be in the form of more frequent check-ups during treatment or proactive side effect management rather than reactive management.

Item Type: Article
Additional Information: ** Article version: AM ** Embargo end date: 31-12-9999 ** From Elsevier via Jisc Publications Router ** Licence for AM version of this article: This article is under embargo with an end date yet to be finalised. **Journal IDs: issn 10788174 **History: issue date 08-01-2020; accepted 07-12-2019
Identification Number:
Page Range: 192-197
SWORD Depositor: Colin Knott
Depositing User: Colin Knott
Date Deposited: 13 Jan 2020 10:25
Last Modified: 17 Mar 2021 17:00

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