Is morphea, cutaneous scleroderma, with no organ involvement a contraindication for radiation in early stage breast cancer as part of breast conservation therapy?

I am not sure anyone can answer this question with a solid yes or no answer. The information we have about limited scleroderma and radiotherapy is for, lack of a better term, limited. We can draw from some experiences to guide the thought process.

1. In one large series of patients from two scleroderma centers, 69 patients with scleroderma were treated with breast radiotherapy as a component of treatment. Importantly, for some (40%ish), the use of radiotherapy preceded the scleroderma diagnosis. Long term follow up was available in 41 patients, and of these, over half were reported to have significant radiation port related fibrosis. Worsening of other scleroderma lung diseases was not noted among those with longitudinal follow up. There was ...

I agree totally with Dr. @Dr. First Last. The main rationale for BCT has always been a superior cosmetic and functional outcome compared with mastectomy, with or without reconstruction. Patients with scleroderma treated with BCT undoubtedly have a much higher frequency of significant fibrosis and consequently unsatisfactory cosmesis and perhaps significant symptoms as well. Why risk that? My general recommendation would be for surgery.

Agree with restrictive use in special cases for RT.