{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2023,10,3]],"date-time":"2023-10-03T05:40:30Z","timestamp":1696311630614},"reference-count":25,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2014,1,24]],"date-time":"2014-01-24T00:00:00Z","timestamp":1390521600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Med Imag Rad Onc"],"published-print":{"date-parts":[[2014,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>The nipple\u2010areolar complex (<jats:styled-content style=\"fixed-case\">NAC<\/jats:styled-content>) has special histological properties with higher melanocyte concentration than breast skin. To date, there are no data describing the late effects on the <jats:styled-content style=\"fixed-case\">NAC<\/jats:styled-content> following breast\u2010conserving therapy (<jats:styled-content style=\"fixed-case\">BCT<\/jats:styled-content>). This study evaluated colour changes in the <jats:styled-content style=\"fixed-case\">NAC<\/jats:styled-content> in patients treated with breast\u2010conserving surgery and adjuvant radiotherapy after 5 years.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Digital photographs obtained at 5 years following breast irradiation from the <jats:styled-content style=\"fixed-case\">S<\/jats:styled-content>t. <jats:styled-content style=\"fixed-case\">G<\/jats:styled-content>eorge and <jats:styled-content style=\"fixed-case\">W<\/jats:styled-content>ollongong (<jats:styled-content style=\"fixed-case\">SGW<\/jats:styled-content>) trial (<jats:styled-content style=\"fixed-case\">NCT<\/jats:styled-content>00138814) were evaluated by five experts using an i<jats:styled-content style=\"fixed-case\">P<\/jats:styled-content>ad\u00ae (Apple Inc., Cupertino, CA, USA) application specifically created for this study. The <jats:styled-content style=\"fixed-case\">SGW<\/jats:styled-content> trial randomised 688 patients with <jats:styled-content style=\"fixed-case\">T<\/jats:styled-content>is\u20102, <jats:styled-content style=\"fixed-case\">N<\/jats:styled-content>0\u20101, <jats:styled-content style=\"fixed-case\">M<\/jats:styled-content>0 carcinoma to the control arm of 50\u2009<jats:styled-content style=\"fixed-case\">G<\/jats:styled-content>y in 25 fractions and boost arm of 45\u2009<jats:styled-content style=\"fixed-case\">G<\/jats:styled-content>y in 25 fractions and 16\u2009<jats:styled-content style=\"fixed-case\">G<\/jats:styled-content>y in 8 fractions electron boost.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 141\/372 (38%) patients had altered <jats:styled-content style=\"fixed-case\">NAC<\/jats:styled-content> (86% lighter, 10% darker). Patients with <jats:styled-content style=\"fixed-case\">C<\/jats:styled-content>eltic skin type had increased likelihood of having an altered <jats:styled-content style=\"fixed-case\">NAC<\/jats:styled-content> (odds ratio (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>), 1.75 (<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.1\u20132.7, <jats:italic>P<\/jats:italic>\u2009=\u20090.011)). On subgroup analysis, those with Celtic skin type receiving biologically equivalent dose (<jats:styled-content style=\"fixed-case\">BED<\/jats:styled-content>) <jats:styled-content style=\"fixed-case\">G<\/jats:styled-content>y<jats:sub>3<\/jats:sub> \u2265 80\u2009<jats:styled-content style=\"fixed-case\">G<\/jats:styled-content>y had <jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> of 3.03 (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.2\u20137.5, <jats:italic>P<\/jats:italic>\u2009=\u20090.016) for having altered colour. There was a dose response with more profound changes seen in the <jats:styled-content style=\"fixed-case\">NAC<\/jats:styled-content> compared with irradiated breast skin if <jats:styled-content style=\"fixed-case\">BED G<\/jats:styled-content>y<jats:sub>3<\/jats:sub> \u2265 80\u2009<jats:styled-content style=\"fixed-case\">G<\/jats:styled-content>y with <jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> of 2.42 (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.1\u20135.6, <jats:italic>P<\/jats:italic>\u2009=\u20090.036).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p><jats:styled-content style=\"fixed-case\">I<\/jats:styled-content>n this Caucasian <jats:styled-content style=\"fixed-case\">BCT<\/jats:styled-content> population, over 30% of patients developed lighter <jats:styled-content style=\"fixed-case\">NAC<\/jats:styled-content> and more commonly in women with <jats:styled-content style=\"fixed-case\">C<\/jats:styled-content>eltic skin type. The degree of this effect increased with higher radiation dose.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1754-9485.12136","type":"journal-article","created":{"date-parts":[[2014,1,24]],"date-time":"2014-01-24T12:34:17Z","timestamp":1390566857000},"page":"229-236","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Breast irradiation causes pallor in the nipple\u2010areolar complex in women with Celtic skin type (result from the <scp>S<\/scp>t. <scp>G<\/scp>eorge and <scp>W<\/scp>ollongong randomised breast boost trial)"],"prefix":"10.1111","volume":"58","author":[{"given":"Yoo Young (Dominique)","family":"Lee","sequence":"first","affiliation":[{"name":"Cancer Care Centre St. George Hospital  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric","family":"Hau","sequence":"additional","affiliation":[{"name":"Cancer Care Centre St. George Hospital  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lois H","family":"Browne","sequence":"additional","affiliation":[{"name":"Cancer Care Centre St. George Hospital  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yaw","family":"Chin","sequence":"additional","affiliation":[{"name":"Cancer Care Centre St. George Hospital  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jessica","family":"Lee","sequence":"additional","affiliation":[{"name":"Cancer Care Centre St. George Hospital  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alison","family":"Szwajcer","sequence":"additional","affiliation":[{"name":"Cancer Care Centre St. George Hospital  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stacy","family":"Cail","sequence":"additional","affiliation":[{"name":"Cancer Care Centre St. George Hospital  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David N","family":"Nolan","sequence":"additional","affiliation":[{"name":"Cancer Care Centre St. George Hospital  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter H","family":"Graham","sequence":"additional","affiliation":[{"name":"Cancer Care Centre St. George Hospital  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2014,1,24]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(05)67887-7"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(12)70042-6"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10549-012-1978-8"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(09)70382-1"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0906260"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0959-8049(97)00312-2"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.1997.15.3.963"},{"key":"e_1_2_6_9_1","volume-title":"Manual for Clinical Research and Treatment in Breast Cancer","author":"Breast Cancer Cooperative Group of the European Organisation for Research and Treatment of Cancer","year":"2004"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/0360-3016(79)90729-6"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/0360-3016(85)90058-6"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2010.11.025"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1440-1673.2003.01128.x"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjps.2004.10.027"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1054\/bjps.2002.3920"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2004.06.257"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.5694\/j.1326-5377.2004.tb05928.x"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2011.08.013"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1118\/1.3633942"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/0360-3016(94)00423-I"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0360-3016(99)00211-4"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1346-8138.2007.00307.x"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1754-9485.2012.02365.x"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1186\/1475-925X-10-24"},{"key":"e_1_2_6_25_1","unstructured":"Sarasohn\u2010KahnJ.How smartphones are changing health care for consumers and providers 2010. 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