Localized Morphea – a Rare but Significant Secondary Complication Following Breast Cancer Radiotherapy

Herrmann, Thomas; Günther, Claudia; Csere, Peter

doi:10.1007/s00066-009-2051-3

Cited by 25 publications

(8 citation statements)

References 36 publications

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“…Alternatively, research has been organized according to the adverse effects potentially related to radiation therapy [9], chemotherapy [10], or adjuvant endocrine therapies [11]. Rare, unusual, or late effects not routinely hypothesized to be associated with breast cancer or its therapies are often investigated only as case reports or case series [12-14]. …”

Section: Introductionmentioning

confidence: 99%

Comprehensive evaluation of the incidence of late effects in 5-year survivors of breast cancer

Lash

Thwin

Yood

et al. 2014

Breast Cancer Res Treat

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Purpose Late effects of breast cancer affect the quality of survivorship. Using administrative data, we compared the occurrence of almost all ICD9 codes among older breast cancer survivors to that among a matched comparison cohort to generate new hypotheses. Methods Breast cancer patients sixty-five years or older diagnosed 1990–1994 in six integrated care settings and who survived at least five years were matched with a cohort of women without a history of breast cancer on care setting, age, and calendar time. We collected data on the occurrence of incident ICD9 codes beginning six years after the breast cancer diagnosis date and continuing to year fifteen, and comparable data for the matched woman. We calculated hazard ratios and 95% confidence intervals associating breast cancer survivorship with incidence of each ICD9 code. We used semi-Bayes methods to address multiple comparisons. Results Older breast cancer survivors had about the same occurrence of diseases and conditions six to fifteen years after breast cancer diagnosis as comparable women. The median of 564 adjusted hazard ratios equaled 1.06, with interquartile range 0.92 to 1.3. The distribution of hazard ratios pertaining to cancer-related ICD codes was shifted towards positive associations, and the distribution pertaining to cardiovascular-related ICD codes was shifted towards negative associations. Conclusions In this hypothesis scanning study, we observed little difference in the occurrence of non-breast cancer-related diseases and conditions among older, long-term breast cancer survivors and comparable women without a history of breast cancer.

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Section: Introductionmentioning

confidence: 99%

Comprehensive evaluation of the incidence of late effects in 5-year survivors of breast cancer

Lash

Thwin

Yood

et al. 2014

Breast Cancer Res Treat

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“…Gynecologists and radio-oncologists should be well aware of the complication of postirradiation morphea of the breast. This radiation reaction seems to be more frequent than assumed, and the breast is disproportionally highly affected compared to other body sites [32]. The risk factors for developing postirradiation morphea are not completely known, but preexisting autoimmune diseases should be noticed.…”

Section: Discussionmentioning

confidence: 99%

“…Another therapeutic option are calcineurin inhibitors. Heparin-containing creams can also be helpful for sclerotic areas [32]. Total excision of the affected area might sometimes be beneficial, and in rare cases a total mastectomy is necessary to stop the painful process [33].…”

Section: Discussionmentioning

confidence: 99%

Irradiation-Induced Morphea: X-Rays as Triggers of Autoimmunity

Laetsch

Hofer²,

Lombriser³

et al. 2011

Dermatology

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We report on 3 females with breast cancer who developed morphea at the site of post-surgery radiotherapy. One was suffering from other autoimmune skin diseases before the diagnosis and treatment of breast cancer. Postirradiation morphea is a potential complication after radiotherapy, particularly radiotherapy for cancer. This troublesome skin disease can occur months to years after treatment, and is associated with remarkable morbidity and pain, and also cosmetic aspects. Therefore, it is crucial to be aware of this condition, and to try to identify patients who might be at an increased risk of developing morphea.

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“…Morphea following radiation exposure is well documented [3–5]. In contrast to idiopathic morphea with a reported incidence of 2.7 per 100,000 in the United States [6, 7], the incidence of postirradiation morphea has been estimated to be as high as 1 in every 500 patients [8, 9].…”

Section: Introductionmentioning

confidence: 99%

“…In contrast to idiopathic morphea with a reported incidence of 2.7 per 100,000 in the United States [6, 7], the incidence of postirradiation morphea has been estimated to be as high as 1 in every 500 patients [8, 9]. It is most frequently described in patients who received focal radiotherapy for breast cancer [3–5, 8–10] but is reported as a complication of radiation therapy for lymphoma [11], head and neck cancer [12, 13], and gastric [14], endocervical [8, 12], and endometrial [15, 16] cancers. For the majority of cases, the area of involved skin is confined to the field of radiation exposure or nearby surrounding tissue.…”

Section: Introductionmentioning

confidence: 99%

Generalized Morphea after Breast Cancer Radiation Therapy

Kushi

Csuka

2011

Case Reports in Rheumatology

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We present a case of a 69-year-old woman who received external beam radiation for the treatment of breast cancer. Seven months later, she developed generalized morphea involving the area of irradiated skin of the breast as well as distant sites of the groin and distal lower extremity. Postirradiation morphea is an uncommon yet well-documented phenomenon, usually confined to the radiated site and the immediate surrounding tissue. To our knowledge, this is only the fourth reported case of morphea occurring distant from the radiation field. While most cases of postirradiation morphea have been shown to either resolve spontaneously or respond to topical corticosteroids, our patient required systemic therapy with methotrexate, which resulted in clinical improvement. With this paper, we hope to bring further awareness to this phenomenon and demonstrate a successful treatment response with the use of methotrexate in postirradiation generalized morphea.

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Localized Morphea – a Rare but Significant Secondary Complication Following Breast Cancer Radiotherapy

Cited by 25 publications

References 36 publications

Comprehensive evaluation of the incidence of late effects in 5-year survivors of breast cancer

Comprehensive evaluation of the incidence of late effects in 5-year survivors of breast cancer

Irradiation-Induced Morphea: X-Rays as Triggers of Autoimmunity

Generalized Morphea after Breast Cancer Radiation Therapy

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