Quantitative assessment of early and late postradiation skin reactions in breast cancer patients

Pilot study of high-frequency ultrasound to assess cutaneous oedema in the conservatively managed breast

“…This finding suggests a need to use the same examination point when performing serial and comparative examinations. In our study, we also noted that the changes in breast-skin thickness predate radiotherapy in those patients who The previous studies [14,15] predominantly did not assess patients prior to commencing radiotherapy and, therefore, implied that the changes in cutaneous thickness relate exclusively to radiotherapy. Our pilot data suggest that cutaneous thickening might also be attributable to axillary surgery.…”

“…Our data are in agreement with several other studies assessing cutaneous thickness in the conservatively managed breast. Warszawski et al [14] and Le Floch et al [15] both showed that cutaneous thickness is increased. Their reported mean thicknesses are remarkably similar to ours for both the treated and untreated breast.…”

“…This was most marked in patients who had undergone axillary dissection, were in the later stages of the radiotherapy treatment course, and in whom there was visual evidence of cutaneous oedema. Several groups have attempted to quantify dermal echogenicity [6,7,14] by measuring the number of low echogenic pixels, the ratio of low echogenic pixels to total pixels in the dermis, or by obtaining several A-scan amplitudes in the area of interest. We feel that the value of these efforts is limited because echogenicity measures do not provide a useful quantitative measure of absolute physical density.…”

“…There are also limited data to suggest that such measurements may be useful to quantify early and late radiation changes in the conservatively treated breast [14,15]. Several studies have suggested that breast size, degree of axillary dissection, and time since treatment are factors affecting the severity and incidence of this breast oedema [1][2][3][4][5].…”