title: Palliation of Ulcerative Breast Lesions with Radiation.
abstract: Patients with advanced breast cancer may experience ulcerative breast lesions. Breast cancer with ulcerative lesions has been shown to severely affect a patient's quality of life (QoL). The role of palliative radiation therapy (RT) in the management of ulcerative breast lesions needs to be further explored.
  
  
  
  We retrospectively reviewed the RT records for all patients who underwent palliative RT for breast cancer at our urban academic medical center. A total of 13 patients were identified, and we herein report their demographics, treatment characteristics, and clinical outcomes.
  
  
  
  The mean age of the patients receiving palliative RT for ulcerative breast cancer was 64 years. All patients had stage IV disease when they were evaluated for RT. The mean radiation dose received for palliative RT was 27.54 Gy in 11 fractions, with a median dose of 30 Gy in 15 fractions. Six (46%) patients had received prior RT to the same breast, with a median dose of 59.5 Gy in 31 fractions. Among these six patients, the average interval between initial RT and ulceration was 69.5 months. The median overall survival for the whole patient cohort since ulceration was 5 months and the mean survival did not differ between patients with previous history of RT and RT-naïve patients (4.50 vs. 4.57; p=0.95). Six out of the nine (69%) patients who received 30 Gy or more reported clinical improvement, whereas none of the four patients who received less than 30 Gy reported any benefit. There were no radiation-associated toxicities reported by patients.
  
  
  
  These data suggest that palliative RT (≥30 Gy) is an efficacious treatment for ulcerative breast cancer with minimal toxicity. Prior RT should not be a contraindication, as patients with previous history of RT have similar low toxicity rates compared to RT-naïve patients.
authors.affiliation: Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, U.S.A.
authors.forename: Prashant
authors.initials: P
authors.lastname: Vempati
authors.affiliation: Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, U.S.A.
authors.forename: Miriam A
authors.initials: MA
authors.lastname: Knoll
authors.affiliation: Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, U.S.A.
authors.forename: Kavita
authors.initials: K
authors.lastname: Dharmarajan
authors.affiliation: Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, U.S.A.
authors.forename: Sheryl
authors.initials: S
authors.lastname: Green
authors.affiliation: Department of Medical Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, U.S.A.
authors.forename: Amy
authors.initials: A
authors.lastname: Tiersten
authors.affiliation: Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, U.S.A. Richard.Bakst@mountsinai.org.
authors.forename: Richard L
authors.initials: RL
authors.lastname: Bakst
mesh_terms: D000328:Adult; D000368:Aged; D001940:Breast / Q000473:pathology* / Q000528:radiation effects; D001943:Breast Neoplasms / Q000473:pathology / Q000532:radiotherapy*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology / Q000532:radiotherapy*; D009367:Neoplasm Staging; D010166:Palliative Care / Q000379:methods*; D011788:Quality of Life; D011832:Radiation Injuries / Q000473:pathology; D011879:Radiotherapy Dosage; D016896:Treatment Outcome
keywords: Palliative radiotherapy; breast cancer; palliative care; ulcerative breast lesions