Delivery of high-dose radiation for recurrence of breast cancer in a patient with hidradenitis suppurativa

Hidradenitis suppurativa (HS) is a chronic inflammatory skin condition characterised by inflammatory nodules, abscesses, sinus tract formation and scarring. There is a lack of evidence for the use of radical radiotherapy for patients with a diagnosis of HS. A 56-year-old woman with a long-standing diagnosis of HS presented with a cutaneous local recurrence of breast cancer. Radical radiotherapy was offered despite issues with previous prolonged postoperative wound healing associated with the underlying HS. A multidisciplinary evaluation was conducted with breast surgeons, dermatologists and radiation oncologists to assess the safety of delivery of radical radiotherapy. Five weeks post radiotherapy, the patient had no significant residual symptoms from her breast cancer treatment for her HS and no escalation of treatment was required for her HS. Factors contributing to safe delivery of radical radiotherapy include medical optimisation prior to and during treatment, radiation dose, radiation technique and vigilant post-treatment surveillance.