Skin necrosis after partial breast irradiation

 

We recently reported on two women who developed skin necrosis after partial breast irradiation.  Notably, both smoked before and after their radiation treatment. Partial breast irradiation is well tolerated in the vast majority of subjects who receive this treatment. Nonetheless, complications can occur, including seromas, fat necrosis and infections. Cavity distance > 7 mm from skin surface has been noted by some authors to affect cosmesis. This distance was 11 in the first and 5 mm in the second subject. Smoking is known to increase perioperative complications after breast implant reconstruction for cancer, and smokers are known to have more late normal tissue complications following whole breast radiotherapy for breast cancer. We therefore believe smoking may have contributed to the complication in these two women, and wonder if others have had similar experiences in women who smoked during their treatment. In the future, we will strongly encourage women who smoke to stop smoking prior to our initiation of partial breast irradiation.

 

 

Bibliographic Reference

Sauter ER et al.: "Skin necrosis in cigarette smokers receiving partial breast irradiation: two case reports", Cases J. 2008 Oct 8;1(1):230. [Epub ahead of print]

 

 

Edward R. Sauter, Steven Westgate, Janice Templemire

Departments of Surgery and Radiology, Ellis Fischel Cancer Center, Columbia, MO and Department of Surgery, University of North Dakota, Grand Forks, ND, USA