After Radiotherapy for Breast Cancer: Are Patients at Higher Risk for Certain Skin Cancers?

By: Joshua D. Madera, MD
Posted: Thursday, May 23, 2024

For patients with breast cancer who receive radiation therapy, the risk of developing a nonkeratinocyte skin cancer may be increased, according to a cohort study published in JAMA Network Open. Therefore, clinicians should advise their patients of this risk, so they can be closely monitored and receive appropriate follow-up care, suggested Eleni Linos, MD, MPH, DrPH, of Stanford University, California, and colleagues.

“Further investigations could explore the effects of radiation dosage and genetic profiles of patients with breast cancer as potential contributors to this elevated risk,” the authors commented.

From 2000 to 2019, a total of 875,880 patients with newly diagnosed breast cancer were recruited from the Surveillance, Epidemiology, and End Results (SEER) Program. All patients were treated with radiotherapy, chemotherapy, or surgery. Patients were subsequently monitored regularly to assess for the development of nonkeratinocyte skin cancer. The type of skin cancer and its location on the body were documented for further analysis.

The study authors reported the development of a nonkeratinocyte skin cancer in 3,839 patients. These skin cancers included melanoma (89.1%), Merkel cell carcinoma (3.2%), hemangiosarcoma (2.7%), and an additional 32 types of skin cancers (5.1%). When the skin of the breast or trunk was assessed, the risk of developing nonkeratinocyte skin cancer for patients who received radiation therapy was significantly higher than that of the general population (standardized incidence ratio [SIR] = 1.57). In addition, analyses of the various skin cancer subtypes revealed a significant SIR for hemangiosarcoma (27.11) and melanoma (1.37). Furthermore, the risk of developing nonkeratinocyte skin cancer was found to be significantly elevated in patients who received radiotherapy compared with those who were treated with chemotherapy or surgery.

Disclosure: For full disclosures of the study authors, visit jamanetwork.com.

JAMA Network Open