PMID- 24456128
OWN - NLM
STAT- MEDLINE
DCOM- 20150413
LR  - 20181202
IS  - 1754-9485 (Electronic)
IS  - 1754-9477 (Linking)
VI  - 58
IP  - 2
DP  - 2014 Apr
TI  - Breast irradiation causes pallor in the nipple-areolar complex in women with 
      Celtic skin type (result from the St. George and Wollongong randomised breast 
      boost trial).
PG  - 229-36
LID - 10.1111/1754-9485.12136 [doi]
AB  - INTRODUCTION: The nipple-areolar complex (NAC) has special histological 
      properties with higher melanocyte concentration than breast skin. To date, there 
      are no data describing the late effects on the NAC following breast-conserving 
      therapy (BCT). This study evaluated colour changes in the NAC in patients treated 
      with breast-conserving surgery and adjuvant radiotherapy after 5 years. METHODS: 
      Digital photographs obtained at 5 years following breast irradiation from the St. 
      George and Wollongong (SGW) trial (NCT00138814) were evaluated by five experts 
      using an iPad(R) (Apple Inc., Cupertino, CA, USA) application specifically created 
      for this study. The SGW trial randomised 688 patients with Tis-2, N0-1, M0 
      carcinoma to the control arm of 50 Gy in 25 fractions and boost arm of 45 Gy in 
      25 fractions and 16 Gy in 8 fractions electron boost. RESULTS: A total of 141/372 
      (38%) patients had altered NAC (86% lighter, 10% darker). Patients with Celtic 
      skin type had increased likelihood of having an altered NAC (odds ratio (OR), 
      1.75 (CI 1.1-2.7, P = 0.011)). On subgroup analysis, those with Celtic skin type 
      receiving biologically equivalent dose (BED) Gy3 >/= 80 Gy had OR of 3.03 (95% CI 
      1.2-7.5, P = 0.016) for having altered colour. There was a dose response with 
      more profound changes seen in the NAC compared with irradiated breast skin if BED 
      Gy3 >/= 80 Gy with OR of 2.42 (95% CI 1.1-5.6, P = 0.036). CONCLUSION: In this 
      Caucasian BCT population, over 30% of patients developed lighter NAC and more 
      commonly in women with Celtic skin type. The degree of this effect increased with 
      higher radiation dose.
CI  - (c) 2014 The Royal Australian and New Zealand College of Radiologists.
FAU - Lee, Yoo Young Dominique
AU  - Lee YY
AD  - Cancer Care Centre, St. George Hospital, Sydney, New South Wales, Australia.
FAU - Hau, Eric
AU  - Hau E
FAU - Browne, Lois H
AU  - Browne LH
FAU - Chin, Yaw
AU  - Chin Y
FAU - Lee, Jessica
AU  - Lee J
FAU - Szwajcer, Alison
AU  - Szwajcer A
FAU - Cail, Stacy
AU  - Cail S
FAU - Nolan, David N
AU  - Nolan DN
FAU - Graham, Peter H
AU  - Graham PH
LA  - eng
PT  - Journal Article
PT  - Randomized Controlled Trial
DEP - 20140124
PL  - Australia
TA  - J Med Imaging Radiat Oncol
JT  - Journal of medical imaging and radiation oncology
JID - 101469340
SB  - IM
MH  - Breast Neoplasms/*epidemiology/*radiotherapy
MH  - Causality
MH  - Comorbidity
MH  - Dose Fractionation, Radiation
MH  - Female
MH  - Humans
MH  - Middle Aged
MH  - New South Wales/epidemiology
MH  - Nipples/*radiation effects
MH  - Organ Sparing Treatments/statistics & numerical data
MH  - Organs at Risk/radiation effects
MH  - Prevalence
MH  - Radiodermatitis/*epidemiology
MH  - Radiotherapy, Conformal/*statistics & numerical data
MH  - Risk Factors
MH  - Skin Pigmentation/*radiation effects
MH  - Treatment Outcome
OTO - NOTNLM
OT  - cosmesis
OT  - late effect
OT  - nipple-areolar complex
OT  - radiotherapy
EDAT- 2014/01/25 06:00
MHDA- 2015/04/14 06:00
CRDT- 2014/01/25 06:00
PHST- 2013/01/14 00:00 [received]
PHST- 2013/10/19 00:00 [accepted]
PHST- 2014/01/25 06:00 [entrez]
PHST- 2014/01/25 06:00 [pubmed]
PHST- 2015/04/14 06:00 [medline]
AID - 10.1111/1754-9485.12136 [doi]
PST - ppublish
SO  - J Med Imaging Radiat Oncol. 2014 Apr;58(2):229-36. doi: 10.1111/1754-9485.12136. 
      Epub 2014 Jan 24.