treating breast in MF patient?

[Scout26]

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Hi, I recently saw an elderly F with mycosis fungoides -- I don't have all her med records yet, but sounds like Stage II; her lesions have primarily been patches of hypopigmentation, with possibly some plaques. She has recently (last in Nov.) been getting phototherapy. No prior RT. She reports what is likely topical agent used several yrs ago.

She was dx with G2 HR+ DCIS lft breast in Nov-Dec. s/p lumpectomy to adequate neg. margins, v. small amt of dz, no necrosis. We recommended she consider no trxt with support of Oncotype dx dcis, but she wants treatment. Her skin currently is in good shape with moderate punctuate hypopigmentation -- primarily on chest, abd, extremities. I can't find anything re: skin toxicity/reaction in terms of her lesions. Any concerns over treating the breast in terms of future MF treatments??

 

[Gfunk6]

I don't really think you are burning major bridges by offering breast radiotherapy. Since you are using photons for breast treatment without bolus, the skin of her breast should be relatively spared. If you are very desirous to absolutely minimize skin dose, APBI would be worthwhile to consider assuming that the DCIS is fairly deep in the breast.

 

[Cookie/Butter]

Isn't mycosis fungoides a kind of cutaneous T cell lymphoma? You'd basically be curing her local disease with radiation so her cosmesis should actually improve (all hypothetical though I've never heard of a case before).