title: Evaluating the effects of aluminum-containing and non-aluminum containing deodorants on axillary skin toxicity during radiation therapy for breast cancer: a 3-armed randomized controlled trial.
abstract: OBJECTIVE
  Deodorant use during radiation therapy for breast cancer has been controversial as there are concerns deodorant use may exacerbate axillary skin toxicity. The present study prospectively determined the use of both aluminum-containing and non aluminum containing deodorants on axillary skin toxicity during conventionally fractionated postoperative radiation therapy for breast cancer.
  
  
  METHODS
  This 3-arm randomized controlled study was conducted at a single center, tertiary cancer hospital between March 2011 and April 2013. Participants were randomized to 1 of 2 experimental groups (aluminum-containing deodorant and soap or non-aluminum containing deodorant and soap) or a control group (soap). A total of 333 participants were randomized. Generalized estimating equations were used to estimate and compare the odds of experiencing high levels of sweating and skin toxicity in each of the deodorant groups to the odds in the control group. The study evaluated a range of endpoints including objective measurements of axilla sweating, skin toxicity, pain, itch and burning. Quality of life was assessed with a validated questionnaire.
  
  
  RESULTS
  Radiation characteristics were similar across all groups. Patients in the deodorant groups did not report significantly different ratings for axillary pain, itch, or burning compared with the control group. Patients in the aluminum-containing deodorant group experienced significantly less sweating than the control; the odds of their sweating being barely tolerable and frequently or always interfering with their daily activities was decreased by 85% (odds ratio, 0.15; 95% confidence interval, 0.03-0.91).
  
  
  CONCLUSIONS
  We found no evidence that the use of either aluminum-containing or non-aluminum containing deodorant adversely effects axillary skin reaction during conventionally fractionated radiation therapy for breast cancer. Our analysis also suggests patients in the aluminum-containing deodorant arm had significantly less sweating without increased symptoms of axillary radiation skin toxicity. These results add to the evidence that the prescription of deodorants during radiation therapy for breast cancer is now questionable.
authors.affiliation: Centre for Nursing Research, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia; School of Nursing and Midwifery Curtin University; Perth, Australia. Electronic address: Lucy.lewis@curtin.edu.au.
authors.forename: Lucy
authors.initials: L
authors.lastname: Lewis
authors.affiliation: Radiation Oncology, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia.
authors.forename: Sharron
authors.initials: S
authors.lastname: Carson
authors.affiliation: Radiation Oncology, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia; School of Surgery, The University of Western Australia, Crawley, Western Australia, Australia.
authors.forename: Sean
authors.initials: S
authors.lastname: Bydder
authors.affiliation: School of Nursing and Midwifery Curtin University; Perth, Australia.
authors.forename: Mariyam
authors.initials: M
authors.lastname: Athifa
authors.affiliation: School of Nursing and Midwifery Curtin University; Perth, Australia; School of Nursing and Midwifery, Edith Cowan University, Perth, Western Australia, Australia.
authors.forename: Anne M
authors.initials: AM
authors.lastname: Williams
authors.affiliation: School of Population Health, The University of Western Australia, Crawley, Western Australia, Australia.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Bremner
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000535:Aluminum / Q000008:administration & dosage / Q000009:adverse effects*; D001365:Axilla / Q000528:radiation effects*; D001943:Breast Neoplasms / Q000532:radiotherapy*; D003836:Deodorants / Q000009:adverse effects* / Q000737:chemistry; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008875:Middle Aged; D016017:Odds Ratio; D011855:Radiodermatitis / Q000139:chemically induced*; D012915:Soaps / Q000009:adverse effects / Q000737:chemistry; D013546:Sweating / Q000187:drug effects*
chemical_list: D003836:Deodorants; D012915:Soaps; D000535:Aluminum