Skip to main content

Advertisement

SpringerLink
Log in

Post-irradiation morphea of the breast: does this pose an issue for reconstruction?

  • Case Report
  • Published:
European Journal of Plastic Surgery Aims and scope Submit manuscript

Abstract

Radiotherapy is a critical component in the treatment of breast cancer, which is the leading cause of cancer death in women. Morphea, or localized scleroderma, is a rare dermatologic disorder characterized by dermal fibrosis and collagen deposition. Most cases of Morphea arise de novo. The aetiology is poorly understood but there are increasing cases in the literature of radiation-induced morphea (RIM) following external beam radiotherapy in breast cancer patients. Its development has functional and cosmetic consequences. Treatment options are limited, with few reports of successful surgical management or formal breast reconstruction. We outline three cases of radiation-induced morphea (RIM) of the breast all of which were successfully treated with excision and flap reconstruction both free and pedicled: two, in the form of latissimus dorsi reconstruction and one, muscle only flap covered with a split skin graft.

Level of Evidence: Level V, therapeutic study.

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

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Siegel RL, Miller KD, Jemal A (2015) Cancer Statistics. CA Cancer J Clin 65(1):5–29

  2. Davis DA, Cohen PR, McNeese MD, Duvic M (1996) Localized scleroderma in breast cancer patients treated with supervoltage external beam radiation: radiation port scleroderma. J Am Acad Dermatol 35:923–927

  3. Crocker HR (1905) Diseases of the skin. Philadelphia: Blakistons; p 633

  4. Colver GB, Rodger A, Mortimer PS, et al. (1989) Post-irradiation morphoea. Br J Dermatol 120:831–835

  5. Peterson LS, Nelson AM, Su WP, et al. (1997) The epidemiology of morphea (localized scleroderma) in Olmsted County 1960-1993. J Rheumatol 24:73–80

  6. Archambeau JO, Pezner R, Wasserman T (1995) Pathophysiology of irradiated skin and breast. Int J Radiat Oncol Biol Phys 31:1171–1185

  7. Meric F, Buchholz TA, Mirza NQ, et al. (2002) Long-term complications associated with breast-conservation surgery and radiotherapy. Ann Surg Oncol 9:543–549

  8. Taylor ME, Perez CA, Halverson KJ, et al. (1995) Factors influencing cosmetic results after conservation therapy for breast cancer. Int J Radiat Oncol Biol Phys 31:753–764

  9. Wazer DE, DiPetrillo T, Schmidt-Ullrich R, et al. (1992) Factors influencing cosmetic outcome and complication risk after conservative surgery and radiotherapy for early-stage breast carcinoma. J Clin Oncol 10:356–363

  10. Ryoo MC, Kagan AR, Wollin M, et al. (1989) Prognostic factors for recurrence and cosmesis in 393 patients after radiation therapy for early mammary carcinoma. Radiology 172:555–559

  11. Laxer RM, Zulian F (2006) Localized scleroderma. Curr Opin Rheumatol 18:606–613

  12. Walsh N, Rheaume D, Barnes P, Tremaine R, Reardon M (2008) Post-irradiation morphea: an underrecognized complication of treatment for breast cancer. Hum Pathol 39:1680–1688

  13. Schaffer JV, Carroll C, Dvoretsky I, Huether MJ, Girardi M (2000) Post-irradiation morphea of the breast presentation of two cases and review of the literature. Dermatology 200:67–71

  14. Bleasel NR, Stapleton KM, Commens C, Ahern VA (1999) Radiation-induced localized scleroderma in breast cancer patients. Australas J Dermatol 40:99–102

  15. Wernicke AG, Goltser Y, Trichter S, et al. (2011) Morphea as a consequence of accelerated partial-breast irradiation. Clin Breast Cancer 11:67–70

  16. Andres C, Kollmar A, Mempel M, et al. (2010) Successful ultraviolet A1 phototherapy in the treatment of localized scleroderma: a retrospective and prospective study. Br J Dermatol 162:445–447

  17. Slavin SA, Gupta S (1997) Reconstruction of scleroderma of the breast. Plast Reconstr Surg 99:1736–1741

  18. Dancey AL, Waters RA (2006) Morphea of the breast. Two case reports and discussion of the literature. J Plast Reconstr Aesthet Surg 59:1114–1117

Download references

Author information

Authors and Affiliations

  1. Department of Plastic Surgery, Cork University Hospital, Wilton Road, Cork, Ireland

    Bilal Rafique, Niall McInerney, Gearoid Fitzgerald & Edward Jason Kelly

  2. Department of General and Breast Surgery, South Infirmary Victoria University Hospital, Cork, Ireland

    Deirdre O’Hanlon

  3. Department of Radiation Oncology, Cork University Hospital, Cork, Ireland

    Jennifer Gilmore

Authors
  1. Bilal Rafique
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Niall McInerney
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Gearoid Fitzgerald
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Deirdre O’Hanlon
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Jennifer Gilmore
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Edward Jason Kelly
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Bilal Rafique.

Ethics declarations

Ethical standards

For this type of study formal consent from a local ethics committee is not required.

Conflicts of interest

Bilal Rafique, Niall McInerney, Gearoid Fitzgerald, Deirdre O’Hanlon, Jennifer Gilmore, Edward Jason Kelly declare they have no conflict of interest.

Patient consent

Patients provided written consent before their inclusion in this study. Additonal consent was obtained for the use of their images.

Funding

This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Rafique, B., McInerney, N., Fitzgerald, G. et al. Post-irradiation morphea of the breast: does this pose an issue for reconstruction?. Eur J Plast Surg 40, 67–70 (2017). https://doi.org/10.1007/s00238-016-1226-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00238-016-1226-2

Keywords

Search

Navigation