Role of radiotherapy in the management of breast cancer with skin involvement.

Purpose: This study aimed to evaluate the effect of radiotherapy (RT) on symptomatic relief and tumor control in patients with breast cancer with skin involvement.

Materials and methods: This retrospective study included patients who received palliative RT of the breast or chest wall for breast cancer with skin involvement. Progression-free survival, freedom from local progression (FFLP), and symptomatic response were evaluated. The prescribed dose to tumor was calculated as the biologically effective dose (BED) using α/β of 4. Symptomatic responses were evaluated until 6 months after RT.

Results: Of the 43 patients included in this study, 48 Gy in 15 fractions was the most common regimen, and the median BED was 86.4 Gy (range, 24.0 to 120.0). With a median follow-up of 15.1 months (range, 1.6 to 63.5), the median FFLP and progression-free survival were 8.4 and 3.6 months, respectively. The 1-year FFLP rates in patients who received BED >75 Gy and BED ≤75 Gy were 78.3% and 49.7%, respectively (p = 0.046). Within 6 months after RT, 75% of patients showed relief of discharge, 67% showed relief of bleeding, and 37% showed relief of pain. There was no grade 3 or higher skin toxicity or other adverse events.

Conclusion: Palliative RT is a safe and effective treatment option for patients with breast cancer with skin involvement, providing symptomatic relief. The administration of BED ≥75 Gy can offer a benefit in achieving durable local control.