Skip to main content

Skin Reactions Associated with Breast Cancer Treatment

  • Chapter
  • First Online:
Common Issues in Breast Cancer Survivors
  • 640 Accesses

Abstract

Despite remarkable advances in the treatment and care of breast cancer, therapeutic regimens used to treat this disease still have a significant impact on the health and well-being of patients undergoing treatment. Understanding the potential side effects of these therapies serves the dual purpose of better preparing patients as they enter into treatment and of allowing the medical community to quickly recognize and mitigate the sequelae of treatment. Some of the most common side effects are adverse skin reactions. There are several important groups of therapeutic agents to consider when classifying common cutaneous side effects: conventional chemotherapeutic agents, HER2-targeted therapies, endocrine therapies, and radiation therapy. Here, we discuss the mechanism of action, common side effects, and optimal management methods for each type of therapy.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 89.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Mockenhaupt M. Epidemiology of cutaneous adverse drug reactions. Allergol Select. 2017;1(1):96–108.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  2. Reyes-Habito CM, Roh EK. Cutaneous reactions to chemotherapeutic drugs and targeted therapies for cancer: part I. Conventional chemotherapeutic drugs. J Am Acad Dermatol. 2014;71(2):203.e201–12; quiz 215–206.

    Google Scholar 

  3. Waks AG, Winer EP. Breast cancer treatment: a review. JAMA. 2019;321(3):288–300.

    Article  CAS  PubMed  Google Scholar 

  4. Sibaud V, Lebœuf NR, Roche H, et al. Dermatological adverse events with taxane chemotherapy. Eur J Dermatol. 2016;26(5):427–43.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Marchetti MA, Noland MM, Dillon PM, Greer KE. Taxane associated subacute cutaneous lupus erythematosus. Dermatol Online J. 2013;19(8):19259.

    Article  CAS  PubMed  Google Scholar 

  6. Stravodimou A, Voutsadakis IA. Hand and foot syndrome associated with docetaxel treatment. Acta Oncol. 2012;51(4):554–6.

    Article  CAS  PubMed  Google Scholar 

  7. Itoh M, Yanaba K, Kobayashi T, Nakagawa H. Taxane-induced scleroderma. Br J Dermatol. 2007;156(2):363–7.

    Article  CAS  PubMed  Google Scholar 

  8. Lau CP, Hui P, Chan TC. Docetaxel-induced nail toxicity: a case of severe onycholysis and topic review. Chin Med J. 2011;124(16):2559–60.

    PubMed  Google Scholar 

  9. Minisini AM, Tosti A, Sobrero AF, et al. Taxane-induced nail changes: incidence, clinical presentation and outcome. Ann Oncol. 2003;14(2):333–7.

    Article  CAS  PubMed  Google Scholar 

  10. Can G, Aydiner A, Cavdar I. Taxane-induced nail changes: predictors and efficacy of the use of frozen gloves and socks in the prevention of nail toxicity. Eur J Oncol Nurs. 2012;16(3):270–5.

    Article  PubMed  Google Scholar 

  11. Huang KL, Lin KY, Huang TW, et al. Prophylactic management for taxane-induced nail toxicity: a systematic review and meta-analysis. Eur J Cancer Care (Engl). 2019;28(5):e13118.

    Article  Google Scholar 

  12. Scotté F, Tourani JM, Banu E, et al. Multicenter study of a frozen glove to prevent docetaxel-induced onycholysis and cutaneous toxicity of the hand. J Clin Oncol. 2005;23(19):4424–9.

    Article  PubMed  Google Scholar 

  13. Scotté F, Banu E, Medioni J, et al. Matched case-control phase 2 study to evaluate the use of a frozen sock to prevent docetaxel-induced onycholysis and cutaneous toxicity of the foot. Cancer. 2008;112(7):1625–31.

    Article  PubMed  Google Scholar 

  14. Marks DH, Qureshi A, Friedman A. Evaluation of prevention interventions for taxane-induced dermatologic adverse events: a systematic review. JAMA Dermatol. 2018;154(12):1465–72.

    Article  PubMed  Google Scholar 

  15. Zawar V, Bondarde S, Pawar M, Sankalecha S. Nail changes due to chemotherapy: a prospective observational study of 129 patients. J Eur Acad Dermatol Venereol. 2019;33(7):1398–404.

    Article  CAS  PubMed  Google Scholar 

  16. Fabian CJ, Molina R, Slavik M, Dahlberg S, Giri S, Stephens R. Pyridoxine therapy for palmar-plantar erythrodysesthesia associated with continuous 5-fluorouracil infusion. Investig New Drugs. 1990;8(1):57–63.

    Article  CAS  Google Scholar 

  17. Wilkes GM, Doyle D. Palmar-plantar erythrodysesthesia. Clin J Oncol Nurs. 2005;9(1):103–6.

    Article  PubMed  Google Scholar 

  18. Weger W, Kränke B, Gerger A, Salmhofer W, Aberer E. Occurrence of subacute cutaneous lupus erythematosus after treatment with fluorouracil and capecitabine. J Am Acad Dermatol. 2008;59(2 Suppl 1):S4–6.

    Article  PubMed  Google Scholar 

  19. Chen GY, Chen YH, Hsu MM, Tsao CJ, Chen WC. Onychomadesis and onycholysis associated with capecitabine. Br J Dermatol. 2001;145(3):521–2.

    Article  CAS  PubMed  Google Scholar 

  20. Paravar T, Hymes SR. Longitudinal melanonychia induced by capecitabine. Dermatol Online J. 2009;15(10):11.

    Article  PubMed  Google Scholar 

  21. Muñoz A, Barceló R, Rubio I, Mañé JM, Ferreiro J, López-Vivanco G. Onycholysis associated with capecitabine in combination with irinotecan in two patients with colorectal cancer. J Natl Cancer Inst. 2003;95(16):1252–3.

    Article  PubMed  Google Scholar 

  22. Susser WS, Whitaker-Worth DL, Grant-Kels JM. Mucocutaneous reactions to chemotherapy. J Am Acad Dermatol. 1999;40(3):367–98; quiz 399–400.

    Article  CAS  PubMed  Google Scholar 

  23. Manzione NC, Wolkoff AW, Sassa S. Development of porphyria cutanea tarda after treatment with cyclophosphamide. Gastroenterology. 1988;95(4):1119–22.

    Article  CAS  PubMed  Google Scholar 

  24. Borroni G, Vassallo C, Brazzelli V, et al. Radiation recall dermatitis, panniculitis, and myositis following cyclophosphamide therapy: histopathologic findings of a patient affected by multiple myeloma. Am J Dermatopathol. 2004;26(3):213–6.

    Article  PubMed  Google Scholar 

  25. Harrist TJ, Fine JD, Berman RS, Murphy GF, Mihm MC Jr. Neutrophilic eccrine hidradenitis. A distinctive type of neutrophilic dermatosis associated with myelogenous leukemia and chemotherapy. Arch Dermatol. 1982;118(4):263–6.

    Article  CAS  PubMed  Google Scholar 

  26. Al-Lamki Z, Pearson P, Jaffe N. Localized cisplatin hyperpigmentation induced by pressure. A case report. Cancer. 1996;77(8):1578–81.

    Article  CAS  PubMed  Google Scholar 

  27. Makrilia N, Syrigou E, Kaklamanos I, Manolopoulos L, Saif MW. Hypersensitivity reactions associated with platinum antineoplastic agents: a systematic review. Met Based Drugs. 2010;2010:207084.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  28. Lotem M, Hubert A, Lyass O, et al. Skin toxic effects of polyethylene glycol-coated liposomal doxorubicin. Arch Dermatol. 2000;136(12):1475–80.

    Article  CAS  PubMed  Google Scholar 

  29. von Moos R, Thuerlimann BJ, Aapro M, et al. Pegylated liposomal doxorubicin-associated hand-foot syndrome: recommendations of an international panel of experts. Eur J Cancer. 2008;44(6):781–90.

    Article  CAS  Google Scholar 

  30. Salzberg M, Thurlimann B, Hasler U, et al. Pegylated liposomal doxorubicin (caelyx) in metastatic breast cancer: a community-based observation study. Oncology. 2007;72(3–4):147–51.

    Article  CAS  PubMed  Google Scholar 

  31. Yuan Y, Orlow SJ, Curtin J, Downey A, Muggia F. Pegylated liposomal doxorubicin (PLD): enhanced skin toxicity in areas of vitiligo. Ecancermedicalscience. 2008;2:111.

    CAS  PubMed  PubMed Central  Google Scholar 

  32. Sheu J, Hawryluk EB, Litsas G, Thakuria M, LeBoeuf NR. Papulopustular acneiform eruptions resulting from trastuzumab, a HER2 inhibitor. Clin Breast Cancer. 2015;15(1):e77–81.

    Article  PubMed  Google Scholar 

  33. Macdonald JB, Macdonald B, Golitz LE, LoRusso P, Sekulic A. Cutaneous adverse effects of targeted therapies: part I: inhibitors of the cellular membrane. J Am Acad Dermatol. 2015;72(2):203–18; quiz 219–220.

    Article  CAS  PubMed  Google Scholar 

  34. Kowalczyk L, Singer CF, Staudigl C, Weber M, Farr A. Adverse mucocutaneous reaction to pertuzumab in a patient with HER2-positive metastatic breast cancer. Breast J. 2017;23(3):352–3.

    Article  PubMed  Google Scholar 

  35. Alexandrescu DT, Vaillant J, Wiernik PH. Trastuzumab/docetaxel-induced nail dystrophy. Int J Dermatol. 2006;45(11):1334–6.

    Article  PubMed  Google Scholar 

  36. Andrew P, Valiani S, MacIsaac J, Mithoowani H, Verma S. Tamoxifen-associated skin reactions in breast cancer patients: from case report to literature review. Breast Cancer Res Treat. 2014;148(1):1–5.

    Article  CAS  PubMed  Google Scholar 

  37. Cruz MJ, Alves S, Baudrier T, Azevedo F. Porphyria cutanea tarda induced by tamoxifen. Dermatol Online J. 2010;16(9):2.

    Article  PubMed  Google Scholar 

  38. Praestegaard C, Kjaer SK, Andersson M, Steding-Jensen M, Frederiksen K, Mellemkjaer L. Risk of skin cancer following tamoxifen treatment in more than 16,000 breast cancer patients: a cohort study. Breast Cancer. 2016;23(6):908–16.

    Article  PubMed  Google Scholar 

  39. Kim YJ, Cohen PR. Anastrozole-induced dermatitis: report of a woman with an anastrozole-associated dermatosis and a review of aromatase inhibitor-related cutaneous adverse events. Dermatol Ther (Heidelb). 2020;10(1):221–9.

    Article  CAS  Google Scholar 

  40. Santoro S, Santini M, Pepe C, et al. Aromatase inhibitor-induced skin adverse reactions: exemestane-related cutaneous vasculitis. J Eur Acad Dermatol Venereol. 2011;25(5):596–8.

    Article  CAS  PubMed  Google Scholar 

  41. Yang TJ, Ho AY. Radiation therapy in the management of breast cancer. Surg Clin North Am. 2013;93(2):455–71.

    Article  PubMed  Google Scholar 

  42. Chan RJ, Larsen E, Chan P. Re-examining the evidence in radiation dermatitis management literature: an overview and a critical appraisal of systematic reviews. Int J Radiat Oncol Biol Phys. 2012;84(3):e357–62.

    Article  PubMed  Google Scholar 

  43. Kole AJ, Kole L, Moran MS. Acute radiation dermatitis in breast cancer patients: challenges and solutions. Breast Cancer (Dove Med Press). 2017;9:313–23.

    CAS  Google Scholar 

  44. Wong RK, Bensadoun RJ, Boers-Doets CB, et al. Clinical practice guidelines for the prevention and treatment of acute and late radiation reactions from the MASCC skin toxicity study group. Support Care Cancer. 2013;21(10):2933–48.

    Article  PubMed  Google Scholar 

  45. Roy I, Fortin A, Larochelle M. The impact of skin washing with water and soap during breast irradiation: a randomized study. Radiother Oncol. 2001;58(3):333–9.

    Article  CAS  PubMed  Google Scholar 

  46. Westbury C, Hines F, Hawkes E, Ashley S, Brada M. Advice on hair and scalp care during cranial radiotherapy: a prospective randomized trial. Radiother Oncol. 2000;54(2):109–16.

    Article  CAS  PubMed  Google Scholar 

  47. Campbell IR, Illingworth MH. Can patients wash during radiotherapy to the breast or chest wall? A randomized controlled trial. Clin Oncol (R Coll Radiol). 1992;4(2):78–82.

    Article  CAS  Google Scholar 

  48. Haruna F, Lipsett A, Marignol L. Topical management of acute radiation dermatitis in breast cancer patients: a systematic review and meta-analysis. Anticancer Res. 2017;37(10):5343–53.

    PubMed  Google Scholar 

  49. Yee C, Wang K, Asthana R, et al. Radiation-induced skin toxicity in breast cancer patients: a systematic review of randomized trials. Clin Breast Cancer. 2018;18(5):e825–40.

    Article  PubMed  Google Scholar 

  50. Lanigan SW, Joannides T. Pulsed dye laser treatment of telangiectasia after radiotherapy for carcinoma of the breast. Br J Dermatol. 2003;148(1):77–9.

    Article  CAS  PubMed  Google Scholar 

  51. Goggins W, Gao W, Tsao H. Association between female breast cancer and cutaneous melanoma. Int J Cancer. 2004;111(5):792–4.

    Article  CAS  PubMed  Google Scholar 

  52. Burt LM, Ying J, Poppe MM, Suneja G, Gaffney DK. Risk of secondary malignancies after radiation therapy for breast cancer: comprehensive results. Breast. 2017;35:122–9.

    Article  PubMed  Google Scholar 

  53. Roychoudhuri R, Evans H, Robinson D, Møller H. Radiation-induced malignancies following radiotherapy for breast cancer. Br J Cancer. 2004;91(5):868–72.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  54. Karagas MR, McDonald JA, Greenberg ER, et al. Risk of basal cell and squamous cell skin cancers after ionizing radiation therapy. For The Skin Cancer Prevention Study Group. J Natl Cancer Inst. 1996;88(24):1848–53.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Lauren Pontius Floyd .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2021 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Floyd, L.P. (2021). Skin Reactions Associated with Breast Cancer Treatment. In: Kimmick, G.G., Shelby, R.A., Sutton, L.M. (eds) Common Issues in Breast Cancer Survivors. Springer, Cham. https://doi.org/10.1007/978-3-030-75377-1_19

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-75377-1_19

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-75376-4

  • Online ISBN: 978-3-030-75377-1

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics