Positive margins, fibroproliferation in the surrounding breast tissue, and necrosis are associated with a marked increase in LR rates. Efforts should be made to achieve negative surgical margins to reduce risk of LR. Death from PT is rare (2%), and only PT that demonstrate uniformly aggressive pathologic features seem to be associated with mortality.
These findings suggest that PLC is a distinct clinical entity that presents at a more advanced stage and may require more aggressive surgical and adjuvant treatment.
Purpose: To investigate the effect of prophylactic use of SafeSkin films strips applied to the inframammary fold during whole breast or reconstructed breast irradiation to avoid moist desquamation to the inframammary fold.
Materials and Methods: Between November 15, 2016 and April 17, 2018, a total of 30 patients were recruited, with 29 patients contributing to analysis, and one patient with bilateral breast cancer. Areas of the breast treatment field not covered by the film were treated with physician's choice of cream, (80% Jean's Cream, 13% Aquafor, and 7% with no topical therapy). The treatment field was photographed weekly. SkinSafe strips were reapplied as needed, but were not applied if erythema was already observed in the inframammary fold. Severity of skin reaction was assessed using the RTOG scale.
Results: There was only one treatment interruption, against medical advice, due to axillary discomfort. One patient refused further trial participation after the first day. No short or long term side effects of film use were noted. Inframammary desquamation developed in only one patient, who tried to replicate the increased comfort of her inframammary tape with adhesive bandages when her tape came off. There was no moist desquamation under the SkinSafe film in the inframammary field in any patient. Axillary moist desquamation, where no film, but rather physician's choice of topical cream was applied, remained at 35%. Areas of skin adjacent to the SkinSafe film showed desquamation in 9.7% of patients, 0.5-1 cm in maximal diameter, all of which had resolved at time of completion.
Conclusions: Prophylactic use of SkinSafe film strips applied to the inframammary fold substantially reduces or eliminates the risk of inframammary desquamation during breast radiation.
Citation Format: Garren D, Le B, Vasireddy R, Flynn L, Forster K, Malina L, Dorfman Y. Prophylactic application of SkinSafe film strips to the inframammary fold prevents moist desquamation during irradiation for breast cancer in a prospective trial [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P3-12-11.
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