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Breast Cancer Treatment Studies · Journal article
Frontiers in Oncology · August 18, 2026
Early or partial results. Treat as a signal, not a conclusion.
This single-center retrospective study of 61 immediately-reconstructed breast cancer patients found that older age and supraclavicular irradiation were independently associated with grade ≥2 acute radiation dermatitis (occurring in 72.1% overall), with supraclavicular irradiation carrying a 6.4-fold increased odds. The authors explicitly characterize these as hypothesis-generating findings requiring validation in larger, multicenter cohorts.
Single-center retrospective cohort study with penalized logistic regression. Women with immediate breast reconstruction (implant/expander or autologous tissue) who completed adjuvant radiotherapy; single center; 57 of 61 (93%) received ≥50 Gy EQD2 to chest wall/breast.. Intervention: Adjuvant intensity-modulated radiotherapy (IMRT) in 25 fractions with 0.5-cm chest-wall bolus; prescribed chest-wall/breast target dose ≥50 Gy EQD2 (in 57/61 patients) or slightly lower in 4 patients.. n = 61. Single center (not specified by name).
Grade ≥2 acute radiation dermatitis occurred in 72.1% of patients (44/61) Older age associated with grade ≥2 RD: OR 2.30 per 10 years (95% CI 1.11–5.87; P=0.023) Supraclavicular irradiation associated with grade ≥2 RD: OR 6.40 (95% CI 1.37–37.37; P=0.018)
Safety was not reported in the material analysed. Check the source before drawing any conclusion about harm.
The findings are exploratory and should not yet alter clinical practice. Clinicians may consider enhanced skin-protective measures for older patients receiving supraclavicular irradiation, but larger validation studies are needed before this becomes a routine risk-stratification approach.
Single-center retrospective study with small sample (n=61), high event rate (72%), and hypothesis-generating findings requiring validation in larger cohorts, limiting confidence in generalizability.
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The findings are exploratory and should not yet alter clinical practice. Clinicians may consider enhanced skin-protective measures for older patients receiving supraclavicular irradiation, but larger validation studies are needed before this becomes a routine risk-stratification approach.
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Background Immediate breast reconstruction is increasingly performed in women with breast cancer, yet many such patients also require post-mastectomy radiotherapy (PMRT), during which acute radiation dermatitis (RD) is common and may compromise reconstruction outcomes and quality of life. Risk factors for RD have been characterized mainly in non-reconstructed or breast-conserving populations, and data specific to immediately-reconstructed patients are scarce. Methods We retrospectively analyzed 61 women with immediate reconstruction (implant/expander or autologous tissue) who completed adjuvant radiotherapy. All patients received intensity-modulated radiotherapy (IMRT) delivered in 25 fractions with a routine 0.5-cm chest-wall bolus; the prescribed chest-wall/breast target dose was ≥50 Gy (EQD2 50 Gy) in 57 of 61 patients (93%) and slightly lower ( 50 Gy) in the remaining 4. Acute RD was graded with the Radiation Therapy Oncology Group (RTOG) scale and dichotomized at grade ≥2. Univariable comparisons used the Mann -Whitney U and Fisher exact tests. Because of the small sample, imbalanced outcome and quasi-separation, Firth penalized-likelihood logistic regression with profile penalized-likelihood 95% confidence intervals (CIs) was used as the primary method. A parsimonious model (age plus supraclavicular irradiation) was pre-specified from clinical priors and univariable P 0.10, and evaluated by likelihood-ratio test, area under the receiver-operating-characteristic curve (AUC) and 1000-fold bootstrap optimism correction. Results Grade ≥2 RD occurred in 72.1% of patients (44/61). In the multivariable model, older age (odds ratio [OR] 2.30 per 10 years, 95% CI 1.11 -5.87; P=0.023) and supraclavicular irradiation (OR 6.40, 95% CI 1.37 -37.37; P=0.018) were associated with grade ≥2 RD; the event rate was 76.9% (40/52) with versus 44.4% (4/9) without supraclavicular irradiation. The model likelihood-ratio χ 2 was 16.30 (P=0.0003); the apparent AUC was 0.719 and the optimism-corrected AUC 0.705. Findings were consistent in an exploratory sensitivity analysis additionally adjusting for tumour laterality. Conclusion In conclusion, grade ≥2 acute RD was common after adjuvant radiotherapy in immediately-reconstructed patients, and older age and supraclavicular (regional nodal) irradiation were associated with the outcome. These hypothesis-generating findings support intensified skin-protective strategies for high-risk patients and warrant validation in larger, multicenter cohorts.
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