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Radiation-induced Breast Telangiectasias Treated with the Pulsed Dye Laser
Anthony M Rossi1, Kishwer S Nehal1, Erica H Lee1
1Memorial Sloan Kettering Cancer Center, Division of Dermatology, New York, New York.
Background And Objectives:
Radiation dermatitis is a frequent sequela of adjuvant radiation therapy for breast cancer. Clinical manifestations include prominent telangiectasias that may be physically disfiguring and psychologically distressing for the patient. The objective of this study was to review cases of breast cancer patients with radiation-induced breast telangiectasias treated with the pulsed dye laser and assess clinical efficacy. The patient's perception of treatment was also reviewed.
Study Design:
A retrospective chart review of patients treated for radiation-induced telangiectasias was conducted at the Dermatology Division of Memorial Sloan-Kettering Cancer Center.
Materials And Methods:
Pre- and post-clinical photos were used to assess clearance by two independent raters. Patient's comments were assessed from visit notes and the treating physicians for the impact of treatment on the patient's overall well-being.
Results:
All patients (n=11) experienced clinical improvement in the radiation-induced telangiectasias. The mean number of treatments was 4.3 (2-9) with an average fluence of 4.2J/cm(2) (585nm platform) and 7.8J/cm(2) (595nm) (4-8 J/cm(2)) used. The mean percent clearance was 72.7 percent (50-90%). Adverse effects were not encountered including those with breast implants or flap reconstruction. Patients reported an improvement in their well-being, including an improved sense of confidence.
Limitations:
LIMITATIONS include the small sample size, nonstandardized digital images, and nonsystematic collection of patient-reported outcomes.
Conclusion:
The pulsed dye laser is an efficacious treatment for radiation-induced breast telangiectasias. Multiple treatments are required for greater than 50-percent clearance and conservative treatment parameters are advised. Patients also reported an improved quality of life.
