Effects of regular bra-wearing on acute skin toxicity in breast-conserving radiotherapy women

Abstract

Pitchaya Thongkhao, et al: Effects of Regular Bra-wearing on Acute Skin Toxicity in Breast-conserving RadiotherapyBreast cancer is the most common cancer in Thai women with the annual Age-Standardized Rate (ASR) per 100,000 being 31.4 in 2015 [1]. According to breast cancer treatments, breast conserving therapy is one of the loco-regional treatment options. Radiotherapy after wide local excision reduces the locoregional recurrence rate as well as the risk of breast cancer death [2][3][4]. Conventional radiotherapy regimens, after breast conservation surgery, deliver a total dose of 46-50 Gy in 23-25 daily fractions over 5 weeks [3][4][5][6][7]. A boost to the tumor bed is recommended in patients with a higher risk of recurrences with the typical boost doses being 10-16 Gy in 4-8 fractions [5-7-12].Acute skin toxicity is the most common side effect of Abstract Purpose: To evaluate the effects of regular bra-wearing during radiotherapy on acute skin toxicity (AST) and the Quality of Life (QOL) in women with breast conserving therapy (BCT). Methods: A prospective study of 99 patients with any stage of breast cancer who underwent BCT. Patients were instructed to wear an appropriate bra then they were classified by total hours of wearing a bra during the radiotherapy treatment course into Non-Bra-Wearing (NBW) (0 hr.) and Bra-Wearing (BW) groups (>0 hr.). The AST was assessed weekly and one week after treatment end by CTCAE v 4.03. The QOL was assessed before and one week after treatment end by The Functional Assessment of Cancer Therapy-Breast Cancer (FACT-B) Thai version 4. Results: 66 patients were in the BW group and 33 patients were in the NBW group. The rate of ≥ G2 AST was lower in the BW group compared to the NBW group (16.7% vs. 54.5%, p<0.001, respectively). In the multivariate analysis, the statistically significant factors that were associated with increased the risk of ≥ G2 AST were NBW (0 hr.) (p<0.001), high body mass index (p=0.001), and the high percentage of maximum dose (p=0.043). There were no differences in all parts of after treatment FACT-B between the two groups (118.4 vs. 114.7, p=0.256, respectively). Conclusions: Regular BW during radiotherapy is not associated with an increased risk of ≥ G2 acute skin toxicity and does not affect the QOL compared to NBW.

Predictive Factors Increasing the Risk of Radiation Toxicity in Patients with Early Breast Cancer

“…Our data support that the incidence of acute skin toxicity was significantly higher in patients receiving boost irradiation, but this is not in agreement of the results of the study done by Borm et al, (2018) who stated that boost RT is not a predictor for the increase of acute skin toxicity. Other predictive factors were found to influence radiation induced skin toxicity like bra cup size, and regular bra wearing as reported by Thongkhao et al, (2019) that regular bra-wearing during radiotherapy, in comparison to non-bra-wearing, resulted in significantly lower rates of ≥ G2 acute skin toxicity. The results of Malekzadeh et al, (2017) suggest that usage of Achillea millefolium, especially at lower doses of radiation, might decrease radiation induced dermatitis.…”

Bra Usage Duration and Breast Cancer Risk: A Case-Control Study

“…This is in line with research that states that there is no relationship between bra usage and breast cancer, especially in terms of bra usage aspects, including cup size, average number of hours worn per day, and age of regular bra usage initiation (Chen et al, 2015). This is further supported by research that states that there is no difference in the occurrence of acute skin toxicity in women with breast cancer who use bras or do not use bras (Thongkhao et al, 2019).…”

MASCC clinical practice guidelines for the prevention and management of acute radiation dermatitis: part 1) systematic review

“…Insufficient evidence was reported to support the use of any interventions for ARD prevention. 166 , 167 , 168 , 169 , 170 , 171 , 172 , 173 , 174 , 175 , 176 , 177 , 178 , 179 , 180 , 181 , 182 , 183 , 184 , 185 , 186 , 187 , 188 , 189 , 190 , 191 , 192 , 193 , 194 , 195 , 196 “n” indicates the number of studies. NS, not specified; RCT, randomized controlled trial; ARD, radiation dermatitis.…”

“…Alternative and multi-component therapies were assessed in 17 RCTs and 16 non-randomized studies 166 , 167 , 168 , 169 , 170 , 171 , 172 , 173 , 174 , 175 , 176 , 177 , 178 , 179 , 180 , 181 , 182 , 183 , 184 , 185 , 186 , 187 , 188 , 189 , 190 , 191 , 192 , 193 , 194 , 195 , 196 ( Appendix C, Table 7 ). Minimal difference was found between patients who used deodorant or antiperspirant and those who washed regularly, 167 , 168 did not use any intervention, 169 or used standard of care, 170 suggesting that antiperspirant/deodorant use should not be encouraged with the intent of preventing ARD.…”