Unilateral keloid formation after bilateral breast surgery and unilateral radiation.
BACKGROUND
Keloid is a hypertrophic scar that may arise within 6 months after injury in susceptible individuals. Different therapies like surgical excision, intralesional steroid injections, local application of pressure, or postoperative irradiation with x-rays or electrons are reported. Although an immediate starting of therapy after surgery is usually recommended, delayed radiotherapy may also be effective.


METHODS
We report on a 48 year old women with a history of an invasive ductal carcinoma in the upper lateral quadrant of the left breast. A breast conserving tumor resection with axillary dissection was performed. An adapting reduction mammaplasty was carried out on the right breast for cosmetic reasons at the same time. 5 weeks after surgery, adjuvant radiotherapy was applied with a total dose of 59 Gy to the left breast. 10 weeks after surgery and by the end of radiotherapy, a keloid had developed on the right breast with reduction mammaplasty, but not on the left irradiated one. 8 months after initial surgery the patient's keloid formation on the right mamma was removed by surgical resection and a keloid prevention with postoperative radiotherapy with 20 Gy was performed.


CONCLUSIONS
Postoperative radiation of the scar prevented effectively keloid formation while simultaneously a hypertrophic scar developed in the non-irradiated scar.
Bölke
E
E
Department of Radiation Therapy and Radiation Oncology, University of Düsseldorf, Germany.
Peiper
M
M
Budach
W
W
Matuschek
C
C
Schwarz
A
A
Orth
K
K
Gripp
S
S
D001943:Breast Neoplasms / Q000628:therapy*; D018270:Carcinoma, Ductal, Breast / Q000628:therapy*; D005260:Female; D006801:Humans; D007627:Keloid / Q000209:etiology* / Q000532:radiotherapy / Q000601:surgery; D015412:Mastectomy, Segmental / Q000009:adverse effects*; D008875:Middle Aged; D011183:Postoperative Complications; D018714:Radiotherapy, Adjuvant