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Observational Study
. 2022 Oct:65:49-54.
doi: 10.1016/j.breast.2022.06.008. Epub 2022 Jul 2.

Radiation recall dermatitis induced by COVID-19 vaccination in breast cancer patients treated with postoperative radiation therapy

Lorenzo Vinante  1 , Angela Caroli  1 , Alberto Revelant  1 , Federica Bertini  1 , Anna Giroldi  1 , Marta Marson  1 , Giovanni Franchin  1 , Elena Muraro  2 , Giulia Brisotto  2 , Agostino Steffan  2 , Lorena Baboci  3
Affiliations
Observational Study

Radiation recall dermatitis induced by COVID-19 vaccination in breast cancer patients treated with postoperative radiation therapy

Lorenzo Vinante et al. Breast. 2022 Oct.

Abstract

Background: and purpose: Radiation recall dermatitis is an adverse event predominantly due to systemic therapy administration after a previous radiation therapy course. Few case reports describe radiation recall dermatitis in breast cancer patients treated with postoperative radiation therapy following COVID-19 vaccination. In this study we investigated the incidence and severity of radiation recall dermatitis after COVID-19 vaccination in irradiated breast cancer patients.

Methods: Patients that received at least one COVID-19 vaccination dose during the year after the end of postoperative breast radiation therapy were included in this observational monocentric study. Local symptoms occurring inside the radiation field after vaccination were patient-reported and scored according to the PRO-CTCAE questionnaire. Descriptive data of radiation recall dermatitis incidence and severity, and potential risk factors were evaluated.

Results: A cohort of 361 patients with 756 administered COVID-19 vaccinations was analyzed. Breast symptoms were reported by 7.5% of patients, while radiation recall dermatitis was considered for 5.5%. The incidence of radiation recall dermatitis per single dose of vaccine was 2.6%, with a higher risk for the first dose compared to the second/third (4.4% vs 1%, p = 0.003), especially when administered within the first month after the end of irradiation (12.5% vs 2.2%, p = 0.0004). Local symptoms were generally self-limited and a few cases required anti-inflammatory drugs.

Conclusions: Radiation recall dermatitis is an uncommon but not rare phenomenon in breast cancer patients that received COVID-19 vaccination within one year after breast irradiation. However, symptoms severity were generally low/mild and reversible. These findings can be useful for patient counseling.

Keywords: Breast cancer; COVID-19 vaccination; Radiation recall dermatitis; Radiation therapy.

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Conflict of interest statement

Declaration of competing interest The authors Vinante L., Caroli A., Bertini F., Relevant A., Giroldi A., Marson M., Franchin G., Muraro E., Brisotto G., Steffan A., Baboci L. disclosed no potential conflicts of interest.

Figures

Fig. 1
Fig. 1
Patients' selection process flowchart EBRT = External Beam Radiation Therapy; IORT= Intraoperative Radiation Therapy.
See this image and copyright information in PMC

References

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