A prospective comparative study of radiotherapy effect upon scar quality

J Plast Reconstr Aesthet Surg. 2021 Aug;74(8):1801-1806. doi: 10.1016/j.bjps.2020.11.044. Epub 2020 Dec 13.

Abstract

Introduction: The effect of radiation on uncomplicated postoperative scars is unclear. This study aimed to analyze irradiated and non-irradiated scars in patients with unilateral breast cancer, who underwent oncoplastic breast reduction surgery and radiation therapy (RT), to identify how postoperative scar changes with radiation.

Methods: Twenty breast scars in 10 patients were analyzed after unilateral breast-conserving surgery, oncoplastic breast reduction, and RT. Scars were assessed using the Vancouver scar scale (VSS) by two independent blinded observers and three-dimensional scar analysis camera. Paired t-test between irradiated and non-irradiated scars in each patient and correlation of scar score differences with potential contributing factors were analyzed.

Results: The VSS was significantly lower for the irradiated scar than that for the non-irradiated contralateral scar (1.40 vs. 4.05, p = 0.001), although time interval from the last radiation to scar assessment had a negative correlation with paired differences of VSS (Spearman's correlation coefficient: -0.637, p = 0.048). Compared with the non-irradiated scar, the irradiated scar showed a significantly high level of hemoglobin (1.04 vs. 1.26, p = 0.017) and melanin (0.55 vs. 0.63, p = 0.03).

Conclusions: Postoperative scars with radiation showed better results in objective and subjective assessments than scars without radiation. These findings suggest that radiation has a positive effect on general scar maturation.

Keywords: Oncoplastic reduction; Postoperative scar; Radiation; Surgery.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Breast Neoplasms / surgery*
  • Cicatrix / radiotherapy*
  • Female
  • Humans
  • Mammaplasty
  • Mastectomy
  • Middle Aged
  • Postoperative Complications / radiotherapy*
  • Prospective Studies