Table 1 Scoring system used to document cutaneous and subcutaneous reactions in breast cancer patients receiving radiotherapy

Grade 0 – Highly radioresistant patients

No toxicity observed: no erythema, desquamation, or pain

Absence of differences between irradiated and nonirradiated skin

Grade 1 – Moderately radioresistant patients

Faint, dull, or bright erythema, psilosis, dry desquamation, mild oedema

Minimal telangiectasia, slight breast asymmetry, mild hyperpigmentation

Grade 2 – Patients with average radiosensitivity

Severe erythema, at least one moist desquamation of small size, moderate oedema

Marked telangiectasia, moderate hyperpigmentation, increased density and palpable firmness, mild oedema

Grade 3 – Moderately radiosensitive patients

Severe or confluent moist desquamation

Partially confluent telangiectasia, severe hyperpigmentation, severe oedema, subcutaneous fibrosis with fixation

Grade 4 – Highly radiosensitive patients

Ulceration, haemorrhage

Totally confluent telangiectasia, very marked density, retraction and fixation. Major aesthetic sequelae in treated breast