title: Objective assessment of dermatitis following post-operative radiotherapy in patients with breast cancer treated with breast-conserving treatment.
abstract: OBJECTIVE
  To evaluate radiation dermatitis objectively in patients with breast cancer who had undergone post-operative radiotherapy after breast-conserving surgery.
  
  
  METHODS
  Skin color (L*, a*, and b* values) and moisture analyses were performed for both breasts (before, after, 1 month, 6 months, and 1 year after radiotherapy) to examine irradiated and non-irradiated skin divided into four quadrants in 118 patients. These patients underwent breast conservative surgery followed by 50 Gy/25 fractions (median) of radiotherapy with or without boost irradiation (10 Gy/5 fractions).
  
  
  RESULTS
  L*, a*, and moisture values were changed by irradiation and maximized at completion or 1 month after radiotherapy. One year after radiotherapy, the skin color had returned to the range observed prior to radiotherapy. However, moisture did not return to previous values even 1 year after treatment. The lateral upper side (quadrant C) showed greater changes than other quadrants in the L* value (darker) at the end of radiotherapy. The Common Toxicity Criteria version 3 scores were found to correlate well with a* and L* values at the completion and 1 month after radiotherapy. Boost radiotherapy intensified reddish and darker color changes at the completion of radiotherapy, while chemotherapy did not intensify the skin reaction caused by radiotherapy.
  
  
  CONCLUSIONS
  Moisture impairment as a result of irradiation lasts longer than color alterations. Objective assessments are useful for analyzing radiation dermatitis.
authors.affiliation: Department of Radiology, National Hospital Organization Osaka National Hospital, Osaka, Japan.
authors.forename: Ken
authors.initials: K
authors.lastname: Yoshida
authors.forename: Hideya
authors.initials: H
authors.lastname: Yamazaki
authors.forename: Tadashi
authors.initials: T
authors.lastname: Takenaka
authors.forename: Eiichi
authors.initials: E
authors.lastname: Tanaka
authors.forename: Tadayuki
authors.initials: T
authors.lastname: Kotsuma
authors.forename: Yuka
authors.initials: Y
authors.lastname: Fujita
authors.forename: Norikazu
authors.initials: N
authors.lastname: Masuda
authors.forename: Keiko
authors.initials: K
authors.lastname: Kuriyama
authors.forename: Mineo
authors.initials: M
authors.lastname: Yoshida
authors.forename: Tsunehiko
authors.initials: T
authors.lastname: Nishimura
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery*; D018270:Carcinoma, Ductal, Breast / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery*; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery*; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D019583:Dose Fractionation, Radiation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007057:Ichthyosis / Q000175:diagnosis; D015412:Mastectomy, Segmental; D008875:Middle Aged; D009367:Neoplasm Staging; D010859:Pigmentation Disorders / Q000175:diagnosis; D011855:Radiodermatitis / Q000175:diagnosis*; D011879:Radiotherapy Dosage; D018714:Radiotherapy, Adjuvant