Aesthetic outcome following breast-conserving surgery assessed by three evaluation modalities in relation to health-related quality of life

Dahlbäck, Cecilia; Ringberg, Anita; Manjer, Jonas

doi:10.1002/bjs.10963

Cited by 17 publications

(35 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Potter et al outlined a core outcome set for breast reconstruction based on Delphi methodology in which 'patient satisfaction with cosmetic outcome' was rated highly amongst medical professionals and patients alike [30]. Patient-Reported Outcome Measures (PROMs) are clearly the most important evaluation of aesthetic outcome but lack objectivity, are affected by the treatment path leading to the final outcome and are consistently discordant from professional assessment, being frequently reported more favourably [9,[31][32][33]. Dahlbäck et al have recently emphasised the importance of PROMs in aesthetic evaluation demonstrating a stronger predictive ability for longer-term health-related quality of life as compared to objective measures or panel assessment [9].…”

Section: Discussionmentioning

confidence: 99%

“…Breast cancer is a common and emotive diagnosis with 54,722 new cases diagnosed in the UK in 2017 [1] Twothirds of women managed surgically for breast cancer undergo Breast-Conserving Treatment (BCT). Aesthetic outcome after BCT has a well-documented influence on patients' psychosocial wellbeing and quality of life [2][3][4][5][6][7][8][9][10]. With advancements in treatment and the excellent survival expectations of 90% at 1 year and 80% at 10 years [1], more women are living with the long-term impact of treatment.…”

Section: Introductionmentioning

confidence: 99%

“…Although anthropometric assessment, subjective rating scales, and photographic measurements have all been used to evaluate aesthetic outcome from breast surgery, none has been widely accepted and each comes with its own well-described limitations [11][12][13][14][15][16][17][18]. The intricacies of aesthetic evaluation are subtle and challenging to articulate and the complexities are reflected in poor agreement between patient, physician, and objective scales [9,19,20].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

3-Dimensional objective aesthetic evaluation to replace panel assessment after breast-conserving treatment

et al. 2020

View full text Add to dashboard Cite

Background Two-thirds of patients with early breast cancer undergo breast-conserving treatment (BCT). Aesthetic outcome is important and has long term implications for psychosocial wellbeing. The aesthetic goal of BCT is symmetry for which there is no gold-standard measure. Panel scoring is the most widely adopted assessment but has well-described limitations. This paper describes a model to objectively report aesthetic outcome using measures derived from 3-dimensional surface images (3D-SI). Method Objective measures and panel assessment were undertaken independently for 3D-SI of women who underwent BCT 1–5 years previously. Univariate analysis was used to test for association between measures and panel score. A forward stepwise multiple linear regression model was fitted to identify 3D measurements that jointly predicted the mean panel score. The fitted model coefficients were used to predict mean panel scores for an independent validation set then compared to the mean observed panel score. Results Very good intra-panel reliability was observed for the training and validation sets (wκ = 0.87, wκ = 0.84). Six 3D-measures were used in the multivariate model. There was a good correlation between the predicted and mean observed panel score in the training (n = 190) and validation (n = 100) sets (r = 0.68, r = 0.65). The 3D model tended to predict scores towards the median. The model was calibrated which improved the distribution of predicted scores. Conclusion A six-variable objective aesthetic outcome model for BCT has been described and validated. This can predict and could replace panel assessment, facilitating the independent and unbiased evaluation of aesthetic outcome to communicate and compare results, benchmark practice, and raise standards.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

3-Dimensional objective aesthetic evaluation to replace panel assessment after breast-conserving treatment

et al. 2020

View full text Add to dashboard Cite

show abstract

“…Based on our findings, future efforts could be undertaken to develop techniques to optimize volumetric and vertical nipple symmetry, and, in turn, patient satisfaction with breast cosmesis, which has been validated as an integral component of long-term quality of life after BCT. 25 , 26 As more women transition to survivorship after being cured of their early stage breast cancer, improving quality of life after cancer treatment becomes paramount.…”

Section: Discussionmentioning

confidence: 99%

Quantitative 3-Dimensional Photographic Assessment of Breast Cosmesis After Whole Breast Irradiation for Early Stage Breast Cancer: A Secondary Analysis of a Randomized Clinical Trial

Chapman

Lei

Patil

et al. 2020

Advances in Radiation Oncology

View full text Add to dashboard Cite

Purpose Our purpose was to use 3-dimensional (3D) surface photography to quantitatively measure breast cosmesis within the framework of a randomized clinical trial of conventionally fractionated (CF) and hypofractionated (HF) whole breast irradiation (WBI); to identify how 3D measurements are associated with patient- and physician-reported cosmesis; and to determine whether objective measures of breast symmetry varied by WBI treatment arm or transforming growth factor β 1 ( TGFβ1 ) status. Methods and Materials From 2011 to 2014, 287 women age ≥40 with ductal carcinoma in situ or early-stage invasive breast cancer were enrolled in a multicenter trial and randomized to HF-WBI or CF-WBI with a boost. Three-dimensional surface photography was performed at 3 years posttreatment. Patient-reported cosmetic outcomes were recorded with the Breast Cancer Treatment Outcome Scale. Physician-reported cosmetic outcomes were assessed by the Radiation Therapy Oncology Group scale. Volume ratios and 6 quantitative measures of breast symmetry, termed F1-6C, were calculated using the breast contour and fiducial points assessed on 3D surface images. Associations between all metrics, patient- and physician-reported cosmesis, treatment arm, and TGFβ1 genotype were performed using the Kruskal-Wallis test and multivariable logistic regression models. Results Among 77 (39 CF-WBI and 38 HF-WBI) evaluable patients, both patient- and physician-reported cosmetic outcomes were significantly associated with the F1C vertical symmetry measure (both P < .05). Higher dichotomized F1C and volumetric symmetry measures were associated with improved patient- and physician-reported cosmesis on multivariable logistic regression (both P ≤ .05). There were no statistically significant differences in vertical symmetry or volume measures between treatment arms. Increased F6C horizontal symmetry was observed in the CF-WBI arm ( P = .05). Patients with the TGFβ1 C-509T variant allele had lower F2C vertical symmetry measures ( P = .02). Conclusions Quantitative 3D image-derived measures revealed comparable cosmetic outcomes with HF-WBI compared with CF-WBI. Our findings suggest that 3D surface imaging may be a more sensitive method for measuring subtle cosmetic changes than global patient- or physician-reported assessments.

show abstract

“…Finally, a study conducted by Dahlback in 2018 concluded that there is no ideal method to evaluate the aesthetic result after surgery, and emphasizes the importance to presenting the results with regard to the patient's health and quality of life [12].…”

Section: Introductionmentioning

confidence: 99%

Development of a computer-aided design software for the quantitative evaluation of aesthetic damage

et al. 2019

View full text Add to dashboard Cite

Concerns associated with the assessment of aesthetic damage or injury raise critical difficulties, such as the scarcity of methodology and standardization that may result in fundamental precepts to establish impartial forms of compensation and aiming the total reparation of bodily injury. The complexity of the aesthetic damage evaluation is associated with the confluence of legal and technical perspectives and expert subjectivity while conducting examination and writing a report. Experts face additional difficulties associated with the objectivity while assessing aesthetic damage, independently on its location or expert skills, due to complex details observed in these lesions. Another situation in the clinical area, doctors (mainly plastic surgeons) and dentists could show the improvement or not, of the aesthetic condition to the patients. In health related areas, the use of information technology has contributed to increase the number of appropriate diagnoses, besides promoting quality, efficiency and satisfaction to health care providers. In order to make this assessment more objective, a technological tool was developed to aid experts in the evaluation of aesthetic damage and report elaboration. The objective was to develop computer-aided design software for aesthetic damage quantification/evaluation that is accessible via internet to be applied as a complementary report on body aesthetic damage. The software uses as a parameter the AIPE method, translated transculturally from Spanish to Portuguese and English. The present study allowed the construction of open access auxiliary software for the evaluation of corporal aesthetic damage. Its use is facilitated by intuitive and interactive filling, and the text may be customized by the user. It transforms the report into PDF and saves all evaluations already done in its own file. Information is encrypted for added security and confidentiality. The software is available on website at https://www.aestheticdamage.com.

show abstract

Aesthetic outcome following breast-conserving surgery assessed by three evaluation modalities in relation to health-related quality of life

Abstract: There is currently no ideal method for evaluating aesthetic outcome after breast-conserving surgery and adjuvant radiotherapy. These results emphasize the use of patient-related outcome measures.

Cited by 17 publications

References 28 publications

3-Dimensional objective aesthetic evaluation to replace panel assessment after breast-conserving treatment

3-Dimensional objective aesthetic evaluation to replace panel assessment after breast-conserving treatment

Quantitative 3-Dimensional Photographic Assessment of Breast Cosmesis After Whole Breast Irradiation for Early Stage Breast Cancer: A Secondary Analysis of a Randomized Clinical Trial

Development of a computer-aided design software for the quantitative evaluation of aesthetic damage

Contact Info

Product

Resources

About