Acute and late morbidity of using a breast positioning ring in women with large/pendulous breasts

Abstract

Purpose: To assess acute and late effects of radiation therapy in women with breast cancer treated with a breast positioning ring. Materials and methods: Fifty-six patients with large and/or pendulous breasts were irradiated using a breast positioning ring. The incidence of acute morbidity was correlated with patient weight and breast ‘size’. Cosmesis was scored at ≥1 year following radiation therapy by the patients. Dose changes in the buildup region under the ring were measured using a computer-controlled scanning system. Results: Moist desquamation (MD) occurred in 60.7% (34/56) of patients treated with the breast ring. The incidence of MD was more common in patients with larger breasts ( P=0.08), the severity necessitating a treatment interruption in 5 out of 56 (9%) patients. Cosmesis at ≥1 year following radiation therapy was scored as ≥ good by all patients. The surface dose under the ring was approximately 85% of the D max dose. Conclusions: The incidence or severity of acute MD in patients treated with a breast positioning ring appears high in patients with large pendulous breasts, and might be related in part, to the increased skin dose due to the positioning ring. To date, there appears to be no significant late normal tissue effects in patients treated with the positioning ring. Additional follow up is needed to assess the long-term consequences of the ring on cosmesis.