Localized scleroderma in breast cancer patients treated with supervoltage external beam radiation: Radiation port scleroderma

doi:10.1016/S0190-9622(96)90116-4

Journal of the American Academy of Dermatology

Volume 35, Issue 6, December 1996, Pages 923-927

https://doi.org/10.1016/S0190-9622(96)90116-4 Get rights and content

Abstract

Background: An association between systemic scleroderma, radiation, and breast cancer has been recognized. However, localized scleroderma in the radiation port of breast cancer patients has been rarely described.

Objective: Our purpose was to describe the concurrence of localized scleroderma, supervoltage radiation, and breast carcinoma.

Methods: Patients were prospectively evaluated in a tertiary care cancer center, and the literature was reviewed.

Results: We describe six patients with breast cancer in whom localized scleroderma developed within their radiation port.

Conclusion: Radiation port localized scleroderma can be a sequela of supervoltage radiation therapy in patients with breast cancer. Recognition is important because localized scleroderma can clinically mimic recurrent breast carcinoma.

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La morphée est une sclérodermie localisée. Depuis les années 1990, elle est décrite comme une complication de la radiothérapie du sein. Il s’agit d’une complication méconnue pour laquelle la radiothérapie apparaît comme un facteur inducteur de processus auto-immun et à laquelle il faut penser devant un érythème en zone traitée, apparaissant en moyenne un an après la fin de l’irradiation. Seul l’examen histologique permet d’en faire la preuve et ainsi d’écarter les diagnostics différentiels que sont principalement la récidive, la mastite (carcinomateuse, infectieuse), la radiodermite chronique et le rappel de l’irradiation. Le traitement de cette complication rare n’est pas consensuel et est le plus souvent topique à base de stéroïdes. L’évolution est marquée par une diminution progressive de l’inflammation initiale tandis que persiste alors une sclérose plus ou moins importante.
Morphoea is a localized scleroderma. Since the 1990s, it is described as a complication after irradiation for breast cancer. This complication is unrecognized and underdiagnosed. Irradiation seems to be a factor inducing an autoimmune process. Clinicians should be aware in case of an erythema in a treated area, appearing on average one year after the end of the irradiation. Histology alone can prove the diagnosis and rule out differential diagnoses: principally mastitis (carcinomatous, infectious), chronic radiodermatitis or radiation recall. Treatment of this rare complication is not consensual; it is most often topical steroids. The evolution is marked by a gradual decrease from the initial inflammation. Sclerosis persists, more or less substantially.

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Clinical and laboratory studyLocalized scleroderma in breast cancer patients treated with supervoltage external beam radiation: Radiation port scleroderma

Abstract

Int J Radiat Oncol Biol Phys

J Am Acad Dermatol

Int J Radiat Oncol Biol Phys

Clin Immunol Immunopathol

Matrix Biol

J Invest Dermatol

Malignancy in progressive systemic sclerosis: association with breast carcinoma [letter]

J Rheumatol

Carcinoma of the breast and scleroderma: four further cases and a literature review

Br J Rheumatol

Breast conservation therapy: severe breast fibrosis after radiation therapy in patients with collagen vascular disease

Cancer

Circumscribed scleroderma induced by postlumpectomy radiation therapy

Cancer

Cancer in systemic sclerosis

Arthritis Rheum

Scleroderma of the breast: light and electron microscopy study

Am Surg

Lichen sclerosus et atrophicus following radiation therapy

Arch Dermatol

Bullous morphea: A distinct entity?

Am J Dermatopathol

Histopathology of the skin

Histologic diagnosis of inflammatory skin diseases

Scleroderma-like changes in chronic graft-versus-host disease

Arch Dermatol

Bleomycin induced scleroderma

J Rheumatol

Post-mammoplasty human adjuvant disease

Br J Rheumatol

Unusual localization of cutaneous chronic graft-versus-host-disease in the radiation field in four cases

Bone Marrow Transplant

Clinical and laboratory study
Localized scleroderma in breast cancer patients treated with supervoltage external beam radiation: Radiation port scleroderma