3008 - Ultrasound-Measured Skin Thickness Changes in Breast Cancer Patients Receiving Radiation

03:00pm - 04:00pm PT

Hall F

Screen: 23

POSTER

Presenter(s)

Jolinta Lin, MD - Emory University School of Medicine, Atlanta, GA

P. V. Wang^1,2, R. L. J. Qiu², R. Martini³, J. Wang⁴, B. Zhou⁵, T. Liu⁴, X. Yang², M. Torres⁶, J. Bai⁷, and J. Y. Lin⁶; ¹Columbia University, New York, NY, ²Department of Radiation Oncology and Winship Cancer Institute, Emory University, Atlanta, GA, ³Emory University School of Medicine, Atlanta, GA, ⁴Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, ⁵Radiation Oncology, Baylor College of Medicine, Houston, TX, ⁶Glenn Family Breast Center, Winship Cancer Institute, Emory University, Atlanta, GA, ⁷Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA

Purpose/Objective(s): Radiation therapy (RT) remains a cornerstone of treatment for early-stage breast cancer, yet most of patients may experience some degree of acute radiation-induced dermatitis. Traditionally, clinical evaluations of skin toxicities often rely on physical examinations and patient-reported outcomes (e.g., RTOG or CTCAE scales), which can be subjective and prone to interobserver variability. As a result, there is growing interest in objective measures to augment standard toxicity assessments. Recent studies suggest that quantitative ultrasound (US) evaluation of skin thickness, performed both during and following RT, may offer a reliable metric to capture radiation-induced changes. By incorporating objective data such as skin thickening with traditional clinical evaluations, clinicians can gain a more precise understanding of treatment-related toxicity in breast cancer patients.

Materials/Methods:

Here, we present data from nine patients with early-stage (0–II) breast cancer who were enrolled in a prospective, longitudinal study while receiving definitive moderately hypofractionated whole breast RT. In addition to skin thickness measurements via US, the clinical trial team collected a range of demographic and clinical data, including skin microbiome profiles, recorded skin toxicities and associated symptoms, and biomarkers of skin inflammation. US examinations were performed on both the irradiated and contralateral (untreated) breasts at four time points: pre-RT, 1 week into RT, 3 weeks into RT, and 3 months post-RT. During each session, patients were positioned supine, and five radial scans were obtained per breast—targeting the upper (12:00), medial (right breast: 3:00; left breast: 9:00), lower (6:00), lateral (right breast: 3:00; left breast: 9:00), and tumor bed regions. Scan durations typically ranged from 5 to 10 minutes, providing detailed longitudinal data on changes in skin thickness and facilitating correlation with clinical, microbiological, and immunological parameters.

Results: Preliminary data show the mean skin thickness changes in the irradiated breast ranging from 0% up to 26%, with variability across patients. Using the contralateral breast as a control, we observed an increase in the mean ratio of irradiated-to-untreated breast skin thickness from approximately 5% at 1 week into RT to 25.2% at 3 months post-RT. Ongoing analyses will integrate clinical characteristics, skin microbiome findings, and inflammatory biomarkers to investigate factors that may correlate with greater skin thickening and higher risk of acute toxicity.

Conclusion: Quantitative US measurements of skin thickness appear to be a valuable objective measure for monitoring acute radiation-induced skin toxicity in breast cancer patients. Combined with standard clinical evaluations and relevant biological data, US assessment may enhance the accuracy and consistency of toxicity monitoring, ultimately improving patient care in radiation oncology.