Do you have particular recommendations for management of a nipple piercing during adjuvant breast radiation?

I have never had a case where this was an issue (i.e., piercing done during the RT). Nevertheless, I would consider this similar to any small wound (e.g. biopsy) within a site being actively irradiated. I certainly have done punch biopsies during chest wall RT and not do not recall having problems. So keep the would area clean, etc. An acute piercing (I think) requires something to stay in the piercing tract to keep the tract open. If this is some sort of metal ring, I would think it best to rem...