Radiation-irritated skin and hyperpigmentation may impact the quality of life of breast cancer patients after whole breast radiotherapy

Abstract

Background This study aimed to investigate skin condition, quality of life, and psychological impact of breast cancer patients after radiation therapy. We designed and administered a questionnaire to breast cancer survivors for better understanding the skin sequelae after radiation therapy. Methods This study performed an anonymous online survey. Invitation join was posted in Facebook groups for Breast Cancer. Content of the questionnaire included basic information and a three-point scale on the degree of skin dryness, sweating, hotness sensation, itchy sensation, presence of pigment deposition, history of severe skin disorder, psychological impact, and quality of life after radiotherapy. Categorical variables were summarized using counts and percentages, and then Mantel–Haenszel chi-square tests, multiple correspondence analysis, Wald chi-square statistics, and logistic regression analyses were performed; P < 0.05 was considered statistically significant. Results In total, 421 breast cancer survivors completed the questionnaire. Among them, 331 (78.62%) reported rarely sweating; 340 (80.76%) reported dry skin; 184 (43.71%) reported itchy skin in addition to dry skin; 336 (79.81%) had severe or mild skin color deposition; and 76 (18.05%) had eczema or contact dermatitis. Dry skin problems were caused by absent sweating and skin dryness in the irradiated skin area, post-RT severe skin disorders, and skin color deposition. Compared with patients sweating normally in the radiation field, patients with absent sweating and hotness sensation in the radiation field had a higher risk of depression. Conclusions This study showed that breast cancer patients after whole breast radiotherapy may experience skin dryness, hypersensitivity and hyper pigmentation in the irradiated skin area. These “radiation-irritated skin” lesions may induce depressive psychological status and impact the quality of life in breast cancer patients after whole breast radiotherapy.

Radiotherapy for patients with Ledderhose disease: Long-term effects, side effects and patient-rated outcome

“…It was reported in 15% of patients, which is comparable to the percentages found in the three previous studies (Table 1) [9][10][11]. Dryness of the skin is a common side effect of radiotherapy, especially in breast cancer [14]. In the long term, it might have a negative effect on physical and mental wellbeing [14].…”

“…Dryness of the skin is a common side effect of radiotherapy, especially in breast cancer [14]. In the long term, it might have a negative effect on physical and mental wellbeing [14]. Skin dryness from radiotherapy for Ledderhose disease seems to persist over time, as the residual dryness was reported more often in the patients who were more than 4 years after end of treatment.…”

Recent advances in radiosensitivity determinants in melanoma

“…Melanins, particularly eumelanins, possess high free radical scavenging abilities conferring significant radioprotective properties [82] and can attenuate radiation therapy efficacy [82]. In addition, radiation may also activate melanocytes, thereby promoting the formation of melanin and hyperpigmentation [83].…”

Quality-of-life and toxicity in cancer patients treated with multiple courses of radiation therapy

“… [11] , [12] , [13] Due to heterogeneity of cancer diseases and their clinical manifestations, evaluation of QoL after RT in different cancer patient populations remains problematic to generalize. [14] , [15] …”

“…[11][12][13] Due to heterogeneity of cancer diseases and their clinical manifestations, evaluation of QoL after RT in different cancer patient populations remains problematic to generalize. [14][15] Chronic hematologic toxicity is another concern in long-term cancer patients treated with multiple courses of systemic therapies and radiotherapy. From a patient perspective, chronic hematologic toxicity may contribute to an exacerbation of infections, fatigue, and increased bleeding time.…”