Late cutaneous effects of a local potent steroid during adjuvant radiotherapy for breast cancer

Abstract

Purpose: The aim of this study was to evaluate whether treatment with a local potent corticosteroid during adjuvant external radiotherapy (ERT) of breast cancer is associated with late skin toxicity. Material and methods: Sixty patients (32 treated with potent corticoid cream versus 28 controls treated with moisturizer) who had been included in a randomized study on prophylactic local corticosteroid treatment under adjuvant ERT in 2009 and 2010 were subjected to a follow-up study in 2016.Assessments of skin texture were registered according to the Late Radiation Morbidity Scoring Scheme (RTOG). Dryness, skin colour and skin thickness were objectively measured using non-invasive instruments. The patients were assessed for differences between their treated and untreated breasts. Results: Skin atrophy was not noticed in any of the 60 patients. Objective instrumental measurements did not reveal any significant differences in skin dryness, colour, pigmentation or skin thickness over the average follow-up time of six years. Clinical assessment based on the RTOG scoring system revealed that the odds ratio of having late skin problems in patients treated with moisturizer compared to patients treated with corticosteroid was 3.2 (95% CI: 1.0–10.1).Patients reported minor cosmetic dermatological sequelae. Seven patients developed telangiectasia, which caused cosmetic inconvenience. Conclusion: In this study, prophylactic corticosteroid treatment to ameliorate radiation dermatitis during adjuvant ERT of breast cancer was not associated with an increase in late skin toxicity nor did it result in skin atrophy. This study is limited by its small sample size, and the risk for false positive findings. Keywords: Adjuvant radiotherapy, Breast cancer, Corticosteroids, Radiation dermatitis, Steroid atrophy, Telangiectasia