Maya Ellison
Breast tape is a popular undergarment solution for women that eliminates the appearance of bra straps and lines. However, if not used properly, it can cause skin irritation and other side effects. In the medical field, tape is also used for postoperative wounds, and clinical consensus has been achieved on its usefulness. In the context of breast cancer treatment, barrier films such as Hydrofilm® and Mepitel® have been investigated as a way to prevent acute radiation dermatitis, with promising results. This paragraph will explore the use of plastic tape for radiation breast sty, including its benefits and potential drawbacks.
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What You'll Learn
Breast cancer patients undergoing whole-breast irradiation (WBI)
Radiation dermatitis (RD) is the most common side effect of whole-breast irradiation (WBI) in breast cancer patients. RD causes skin injury and has a major impact on the quality of life of patients. To prevent RD, barrier films such as Hydrofilm® and Mepitel® are placed on the skin for the duration of the radiation treatment. These films have been proven to lead to improved outcomes, with fewer adverse reactions and reduced pain, itching, burning, and limitations in daily activities.
In a randomized dual-center assessment, Hydrofilm polyurethane films were applied to either the medial or lateral breast-half of 74 patients with breast cancer undergoing WBI. The study found that radiation dermatitis severity was reduced in the hydrofilm compartments, with decreased erythema and hyperpigmentation. Hydrofilm also prevented moist desquamation, a common side effect of WBI, and reduced patients' treatment-related symptoms.
Another study investigated the use of Mepitel film in WBI and post-mastectomy radiotherapy. The results showed a significant reduction in radiation dermatitis severity in patients undergoing post-mastectomy radiotherapy and in patients treated with a total dose of 50 Gy during WBI.
Overall, the use of barrier films has been shown to be an effective tool in the prevention of RD in patients receiving WBI. These films improve patient outcomes and reduce the side effects associated with radiation treatment.
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Hydrofilm® and Mepitel® films as barrier films
Radiation dermatitis (RD) is the most common side effect of adjuvant whole-breast or chest wall irradiation, which significantly impacts the quality of life of patients. Barrier films, such as Hydrofilm® and Mepitel® films, are polyurethane dressings that can be applied directly to the skin and remain on the skin for the duration of the radiation treatment. They are sterile, transparent, and breathable, with Hydrofilm using a hypoallergenic polyacrylate adhesive and Mepitel film using a silicone-based adhesive.
These barrier films provide a semi-permeable mechanical barrier that protects the skin from friction and excess moisture, facilitating the repair of radiation-damaged tissue while safeguarding against additional trauma. They have been shown to significantly reduce the development of RD grade ≥ 2 in breast and head and neck cancer patients, with Hydrofilm also positively impacting patient-reported outcomes (PROs).
Meta-analyses of randomised controlled trials have demonstrated the effectiveness of Hydrofilm® and Mepitel® barrier films in reducing the incidence and severity of radiation dermatitis and moist desquamation. Patients reported less pain, itching, burning, and limitations in daily activities. The side effects of using these films are mild and self-limiting, and they have a high acceptance rate among patients, along with a favourable cost-benefit ratio.
While the evidence supporting the use of barrier films is limited by small sample sizes and a lack of information on radiation treatment techniques, the films have been shown to improve clinician- and patient-reported outcomes. They are a valuable tool in preventing RD, especially in Caucasian patients receiving whole-breast or chest wall irradiation.
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Reduction of radiation dermatitis severity
Radiation dermatitis is a frequent side effect in breast cancer patients undergoing whole-breast irradiation (WBI). It is characterised by skin injury and carries the risk of limiting the dose of radiation or interrupting treatment, which could negatively impact treatment efficacy.
There is currently no gold standard in the management of radiation dermatitis, but many studies have investigated the use of topical therapies, dressings, and films as preventative agents or for managing skin reactions.
One such study found that Mepitel Film, a semi-permeable dressing/film, can be used from the first day of radiotherapy, and its transparency allows for skin appearance assessment without removal. It has been shown to reduce the severity of radiation dermatitis, particularly in patients undergoing post-mastectomy radiotherapy and those treated with a total dose of 50 Gy during WBI.
Another investigation into the prophylactic application of polyurethane films (Hydrofilm) observed a reduction in the incidence and severity of radiation dermatitis during normofractionated WBI. Hydrofilm is a thin, transparent, hypoallergenic, sterile, semi-permeable, waterproof, and bacteria-proof film that can remain on the skin for several weeks without causing trauma upon removal.
In addition to films, certain dressings have been shown to be effective in reducing the severity of radiation dermatitis. For example, a single-blind randomised controlled trial found that the prophylactic application of StrataXRT dressings resulted in a reduced risk of developing acute radiation dermatitis (ARD) and delayed skin toxicity development. Two other studies confirmed these findings, with one demonstrating a reduction in objectively measured ARD severity in the StrataXRT group and the other proving its non-inferiority to Mepitel film in ARD prevention.
Furthermore, a study by Niazi et al. compared the prophylactic use of silver clear nylon dressing with no prophylaxis and found a significant reduction in the severity of radiation-induced dermatitis (RID) on the last day of treatment.
While there is no definitive treatment for RID, basic recommendations from the Multinational Association of Supportive Care in Cancer (MASCC) guidelines include advising patients to wear loose clothing, use electric razors if necessary, and avoid cosmetics and perfumes during radiotherapy.
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Improved patient-reported outcomes
Plastic tape, or kinesiology tape, is used during breast cancer treatment to manage complications such as lymphedema and seroma fluid. Lymphedema is a chronic and progressive condition resulting from an abnormality or damage to the lymphatic system, causing an abnormal increase in tissue proteins, edema, chronic inflammation, and fibrosis. Seroma is a collection of fluid that builds up near the surgical scar, which can be disrupted when lymph nodes are removed during surgery.
Kinesiology taping is a continuous treatment method that can be used to aid in fluid drainage and provide relief. When tape is applied to stretched skin, it creates "convolutions" in a neutral position, lifting the skin and creating pressure differences between the various tapes. This stimulates the fascial structures and provides a draining and pain-relieving effect. The taped area will form convolutions to increase the space between the skin and muscles, promoting the flow of blood and lymphatic fluid. Kinesiology tape is also waterproof, allowing patients to shower without removing the tape, and can be worn for up to 4 days.
Several studies have been conducted to assess the efficacy of kinesiology taping for treating breast cancer-related lymphedema. One single-blind, controlled pilot study found that K-tape could not replace the bandage and should not be an alternative choice for lymphedema patients. Another study found that K-tape appeared to be ineffective at treating secondary lymphedema after breast cancer treatment. However, many practitioners use it in clinical practice in European countries, and it has been reported to have beneficial effects.
In addition to kinesiology tape, polyurethane films such as Hydrofilm® and Mepitel® have been investigated as a prophylactic measure to reduce the incidence and severity of radiation dermatitis, the most common side effect of whole-breast irradiation. These films are sterile, semi-permeable, waterproof, and bacteria-proof, and can remain on the skin for several weeks without causing trauma upon removal. The use of these barrier films has led to improved patient-reported outcomes, including fewer reports of pain, itching, burning, and limitations in daily activities.
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Less patient-reported pain, itching, burning, and limitations in daily activities
Radiation dermatitis (RD) is the most common acute side effect of whole-breast or chest wall irradiation in breast cancer patients. This side effect can cause pain, itching, burning, and limitations in daily activities for patients.
To prevent this, barrier films such as Hydrofilm polyurethane films are applied to the skin. Hydrofilm is a thin, transparent, semi-permeable, and waterproof film that sticks to the skin using a hypoallergenic adhesive. It is approved as a primary dressing to cover post-operative wounds and can remain on the skin for several weeks.
The use of Hydrofilm has been shown to reduce the severity of radiation dermatitis by at least 27% and decrease the frequency of moist desquamation by at least 28%. In a study of 78 breast cancer patients, moist desquamation rates were reduced from 26% to 0%, and patients reported significantly reduced symptoms of pain, itching, burning, and limitations in daily activities.
Another study analyzed the results of 5 RCTs involving 663 patients, finding that barrier films led to improved patient-reported outcomes, including less pain, itching, burning, and limitations in daily activities. The films also had a high acceptance rate among patients and a favourable cost-benefit ratio.
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Frequently asked questions
Whole-breast irradiation is a standard of care after breast-conserving surgery for breast cancer. Conventional fractionation regimens in WBI are typically performed over a period of 5–6 weeks with fractions (fx) of 1.8–2 Gy per day.
Radiation-induced skin injury is the most frequent side effect in breast cancer patients undergoing WBI.
Barrier films, such as Hydrofilm® and Mepitel® film, have been used as a prophylactic measure to prevent acute radiation dermatitis in several trials. These films are sterile, transparent, and breathable, and can be applied directly to the skin to protect it from friction and excess moisture.
The use of barrier films has led to improved clinician- and patient-reported outcomes, including reduced pain, itching, burning, and limitations in daily activities.
The films should be applied directly to the skin and can remain in place for the duration of the radiation treatment. They are semi-permeable, waterproof, and bacteria-proof, and can be removed without causing trauma to the skin.
