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Quantitative changes in skin composition parameters due to chemotherapy in breast cancer patients: a cohort study

  • Epidemiology
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Abstract

The objective of this study is to evaluate objective changes in water content, sebum content, transepidermal water loss (TEWL), and melanin due to breast cancer chemotherapy, and their association with subjective symptoms. Prospective cohort study of 61 patients 18 years of age or older with a postoperative diagnosis of stage I–III breast cancer, who received adjuvant chemotherapy between February and September 2012 at an outpatient breast cancer clinic in Korea. Objective skin parameters, measured using a noninvasive bioengineering device, and patient-reported dryness and dullness were assessed before chemotherapy, after two cycles of chemotherapy, and 1, 3, and 6 months after completion of chemotherapy. Water content (−6.5 %), sebum (−75.5 %), and TEWL (−22.4 %) significantly decreased during chemotherapy compared to pre-chemotherapy levels (all p values <0.001). These parameters were lowest at 1 month after completion of chemotherapy and recovered thereafter but did not return to baseline levels after 6 months of follow-up. Melanin increased during chemotherapy with respect to pre-chemotherapy levels (8.4 %; p < 0.001) but decreased from the first month after completion of chemotherapy through the end of follow-up (−17.1 %; p < 0.001). The patterns of skin changes were similar in patients with or without hormone therapy. Most of patients reported dryness (57.9 %) and dullness (49.1 %) after chemotherapy, and patient-reported dryness was significantly associated with decreased sebum content. Chemotherapy-induced substantial changes in objective skin composition parameters. These changes persisted after 6 months from completion of chemotherapy and were associated with patient-reported symptoms. Additional research is needed to translate these findings into interventions for improving the dermatologic quality of life of breast cancer patients undergoing chemotherapy.

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Abbreviations

T1:

Before chemotherapy

T2:

After two cycles of chemotherapy

T3:

1 Month after completion of chemotherapy

T4:

3 Months after completion of chemotherapy

T5:

6 Months after completion of chemotherapy

CG:

Received chemotherapy only group

CHG:

Received chemotherapy and hormone therapy

AC:

Doxorubicin, cyclophosphamide

FAC:

Cyclophosphamide, doxorubicin, fluorouracil

T:

Docetaxel

TEWL:

Transepidermal water loss

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Funding

This work was supported by the research was supported by AMOREPACIFIC and the Korea Breast Cancer Foundation, the Faculty Research Fund, Sungkyunkwan University (2013).

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Author notes

    Authors and Affiliations

    1. Department of Health Sciences and Technology, Samsung Advanced Institute of Health Sciences and Technology (SAIHST), Sungkyunkwan University, 50, Irwon-Dong, Gangnam-Gu, Seoul, 135-710, South Korea

      Danbee Kang & Juhee Cho

    2. Cancer Education Center, Samsung Comprehensive Cancer Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea

      Im-Ryung Kim & Juhee Cho

    3. Division of Hematology/Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea

      Young Hyuck Im, Yeon Hee Park & Jin Seok Ahn

    4. Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea

      Jeong Eon Lee & Seok Jin Nam

    5. Skin Research Institute, AMOREPACIFIC R&D Center, Yongin, South Korea

      Hyeokgon Park, Eunjoo Kim & Hae Kwang Lee

    6. Department of Dermatology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea

      Dong-Youn Lee

    7. Departments of Epidemiology and Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA

      Juhee Cho

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    Correspondence to Juhee Cho.

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    Dong-Youn Lee and Juhee Cho contributed equally to this study.

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    Figure S1 (TIFF 58 kb)

    Trajectories of water content (a), sebum content (b), transepidermal water loss (TEWL) (c), and melanin index (d) on the cheek according to the type of chemotherapy before, after two cycles of chemotherapy, and after completion of chemotherapy. AC doxorubicin and cyclophosphamide (n = 16); FAC cyclophosphamide, doxorubicin, and fluorouracil (n = 16); AC + T doxorubicin, cyclophosphamide, and docetaxel (n = 29). Hormone therapy was received by 87.5, 50, and 72.4% of those receiving AC, FAC, and AC + T, respectively Differences between the slopes in the three groups were not statistically significant. The chemotherapy regimen included doxorubicin, cyclophosphamide, cyclophosphamide, doxorubicin, fluorouracil, and taxotere. T1 before chemotherapy, T2 after two cycles of chemotherapy, T3 1 month after completion of chemotherapy, T4 3 months after completion of chemotherapy, T5 6 months after completion of chemotherapy

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    Kang, D., Kim, IR., Im, Y.H. et al. Quantitative changes in skin composition parameters due to chemotherapy in breast cancer patients: a cohort study. Breast Cancer Res Treat 152, 675–682 (2015). https://doi.org/10.1007/s10549-015-3502-4

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    • DOI: https://doi.org/10.1007/s10549-015-3502-4

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