Randomized Control Trial: Evaluating Aluminum-Based Antiperspirant Use, Axilla Skin Toxicity, and Reported Quality of Life in Women Receiving External Beam Radiotherapy for Treatment of Stage 0, I, and II Breast Cancer


      Standard skin care instructions regarding the use of antiperspirants during radiotherapy to the breast varies across North America. Women have articulated that when instructed to not use antiperspirant, the potential for body odor is distressing. Historical practices and individual opinions have often guided practice in this field. The present study had 2 purposes. To evaluate whether the use of aluminum-based antiperspirant while receiving external beam radiotherapy for stage 0, I, or II breast cancer will increase axilla skin toxicity and to evaluate whether the use of antiperspirant during external beam radiotherapy improves quality of life.


      A total of 198 participants were randomized to either the experimental group (antiperspirant) or control group (standard care-wash only). The skin reactions in both groups were measured weekly and 2 weeks after treatment using the National Cancer Institute Common Toxicity Criteria Adverse Events, version 3, toxicity grading criteria. Both groups completed the Functional Assessment for Chronic Illness Therapy’s questionnaire for the breast population quality of life assessment tool, with additional questions evaluating the effect of underarm antiperspirant use on quality of life before treatment, immediately after treatment, and 2 weeks after treatment during the study.


      The skin reaction data were analyzed using the generalized estimating equation. No statistically significant difference was seen in the skin reaction between the 2 groups over time. The quality of life data also revealed no statistically significant difference between the 2 groups over time.


      Data analysis indicates that using antiperspirant routinely during external beam radiotherapy for Stage 0, I, or II breast cancer does not affect the intensity of the skin reaction or the self-reported quality of life. This evidence supports that in this particular population, there is no purpose to restrict these women from using antiperspirants during their treatment, and the decision to use an antiperspirant or not in this setting should be left to the discretion of the patient.


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      1. National Cancer Institute [NCI]. What you need to know about breast cancer. NCI booklet (Publication no. 09-1556). Available at: Accessed April 30, 2011.

        • Moore-Higgs G.J.
        Radiation options for early stage breast cancer.
        Semin Oncol Nurs. 2006; 22: 233-241
        • Tereffe W.
        Accelerated hypofractionated whole-breast radiotherapy: A viable alternative to standard treatment?.
        Breast Dis. 2008; 19: 208-211
      2. Bruner D.W. Haas M.L. Gosselin-Acomb T.K. Manual for radiation oncology nursing practice and education. Oncology Nursing Society, Pittsburgh2005
        • Graham P.H.
        • Graham J.L.
        Use of deodorants during adjuvant breast radiotherapy: A survey of compliance with standard advice, impact on patients and a literature review on safety.
        J Med Imaging Radiat Oncol. 2009; 53: 569-573
        • Campbell J.
        • Lane C.
        Developing a skin care protocol for patients undergoing radiotherapy treatment.
        Prof Nurse. 1996; 12: 105-108
        • Campbell I.R.
        • Illingworth M.H.
        Can patients wash during radiotherapy to the breast or chest wall? A randomized control trial.
        Clin Oncol. 1992; 4: 78-82
        • Roy I.
        • Fortin A.
        • Larochelle M.
        The impact of skin washing with water and soap during breast irradiation: A randomized study.
        Radiother Oncol. 2001; 58: 333-339
        • Aistars J.
        The validity of skin care protocols for external radiation.
        Clin J Oncol Nurs. 2006; 10: 487-492
        • Boulderson A.
        Skin care recommendations during radiotherapy: A survey of Canadian practices.
        Can J Med Radiat Technol. 2003; 34: 3-12
        • McQuestion M.
        Evidence-based skin care management in radiation therapy.
        Semin Oncol Nurs. 2006; 22: 163-173
        • Gee A.
        • Moffitt D.
        • Churn M.
        • et al.
        A randomized control trial to test a non-metallic deodorant used during the course of radiotherapy.
        J Radiother Prac. 2000; 1: 205-212
        • Burch S.E.
        • Parker S.A.
        • Vann A.M.
        • et al.
        Measurement of 6-MN x-ray surface dose when topical agents are applied prior to external beam irradiation.
        Int J Radiat Oncol Biol Phys. 1997; 38: 447-451
        • Webster K.
        • Odom L.
        • Peterman A.
        • et al.
        The Functional Assessment of Chronic Illness Therapy (FACIT) measurement system: Validation of version 4 of the core questionnaire.
        Qual Life Res. 1999; 8: 604
        • Lachin J.M.
        Introduction to sample size determination and power analysis for clinical trials.
        Control Clin Trials. 1981; 2: 93-113
        • Bennett C.
        An investigation into the use of a non-metallic deodorant during radiotherapy treatment: A randomized controlled trial.
        J Radiother Pract. 2009; 8: 3-9
        • Ballinger G.A.
        Using generalized estimating equations for longitudinal data analysis.
        Organizational Res Methods. 2004; 7: 127-150
        • Liang K.Y.
        • Zeger S.I.
        Longitudinal data analysis using generalized linear models.
        Biometrika. 1986; 73: 13-22
        • Lipscomb J.
        • Gotay C.C.
        • Snyder C.
        Outcome assessment in cancer: Measures, methods and applications.
        Cambridge University Press, New York2005
        • Theberge V.
        • Harel F.
        • Dagnault A.
        Use of axillary deodorant and effect on acute skin toxicity during radiotherapy for breast cancer: A prospective randomized noninferiority trial.
        Int J Radiat Oncol Phys. 2009; 75: 1048-1052


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