How do you approach breast conserving therapy in a woman who has formed bothersome keloids after prior surgeries?
Is there any alteration in approach from the medical, surgical, or radiation oncology perspective that can mitigate the risk of forming keloids without significantly compromising potential for cure or healing?
Answer from: Radiation Oncologist at Academic Institution
I have only seen a few patients who developed keloids following breast surgery, whether or not they received radiation therapy. That also is true of individuals who have had keloids on other parts of their body. Hence, this fortunately seems to be a rare event, and I do not think prophylactic steroi...
Answer from: Radiation Oncologist at Community Practice
Anecdotally, I have seen less keloid formation in women after BCT and RT even though RT is delivered after wound healing. In the past, for a few patients, I have done boost plan post op within 24 hrs (4Gy x3) treating scar and surgical bed followed by adjuvant whole breast after healing. When doing ...
Answer from: Radiation Oncologist at Academic Institution
I have managed this a couple of times. In one patient, I treated her incisions with standard 6-7 Gy x3 with electrons on days 1-3 postop, then completed WBI later. Another patient I plan on treating this month developed keloids after lumpectomy/SLNBx a year ago, but never followed up for adjuvant th...