Cosmetic Evaluation Methods Adapted to Asian Patients after Breast-Conserving Surgery and Examination of the Necessarily Elements for Cosmetic Evaluation

Abstract

PurposeAlthough various strategies have been reported, there are no defined criteria for cosmetic evaluation methods after breast-conserving surgery (BCS). Since Asians tend to have smaller breasts, indistinct inframammary folds, and conspicuous scars, differences in the cosmetic results are expected. So we examined two subjective methods and one objective method to determine the differences, and elements necessary for a cosmetic evaluation after BCS.MethodsFrontal photographs of 190 Japanese were evaluated using the Harris scale (Harris) and the evaluation method proposed by the Japanese Breast Cancer Society Sawai group (Sawai group) as the subjective methods, and the Breast Cancer Conservation Treatment cosmetic results (BCCT.core) as the objective method, respectively. In order to examine the necessary elements for developing a new ideal method, 100 out of 190 were selected and assessed separately by six raters using both the Harris and modified Sawai group methods in the observer assessment. The correlation between the two methods was examined using the Spearman rank-correlation coefficient.ResultsThe results of the BCCT.core and the other two methods were clearly different. In the observer assessment, the consensuses of the six raters were evaluated as follows: 27, 27, 26, and 20 cases were evaluated as "excellent," "good," "fair," and "poor," respectively. For the Spearman rank-correlation coefficient, values higher than 0.7 indicated a strong correlation, as seen by the values of 0.909 for the breast shape and 0.345 for the scar. The breast shape accounted for the most significant part of the evaluation, and the scar had very little correlation.ConclusionIn this study, we recognized a clear difference between the subjective and objective evaluation methods, and identified the necessary elements for cosmetic evaluation. We would like to continue developing an ideal cosmetic evaluation that is similar to subjective one and is independent from raters.

Outcomes of Different Quality of Life Assessment Modalities After Breast Cancer Therapy

“…In addition to AO scoring tool standardization, augmentation of available tools to incorporate aspects of patient race and ethnicity, cultural influences, sexuality, and self-views of body image would substantially improve the perspective necessary to holistically assess surgical outcomes . Efforts to develop such tailored tools have been undertaken, especially in the context of race and ethnicity, but expert consensus appraisal and standardization of these tools remains to be achieved . Furthermore, adjustment of AO tools to the specific surgical approach undertaken (eg, robotic vs open nipple-sparing mastectomy) would set a realistic benchmark for AO expectations and therefore outcome assessment .…”

“… 35 , 37 , 38 Efforts to develop such tailored tools have been undertaken, especially in the context of race and ethnicity, but expert consensus appraisal and standardization of these tools remains to be achieved. 39 Furthermore, adjustment of AO tools to the specific surgical approach undertaken (eg, robotic vs open nipple-sparing mastectomy) would set a realistic benchmark for AO expectations and therefore outcome assessment. 35 , 36 , 38 As an adjunct to the development of optimized AO tools in future research, dedicated and standardized body image tools in BC should be developed to provide pragmatic and all-inclusive views on preestablished body perceptions in this patient group ( Figure 4 ).…”

Combined Patients and Medical Related Cosmetic Breast Cancer Outcomes—A Preferred Approach to Outcomes Assessment

“…[42]. The software may need refinement when used to evaluate the cosmetic outcome of an Asian population [43].…”

Feasibility of modified radical mastectomy with nipple-areola preservation combined with stage I prosthesis implantation using air cavity-free suspension hook in patients with breast cancer

“…The overall satisfaction was defined as the proportion of satisfied and moderately satisfied patients. The breast shape of the patients who underwent SMALND was evaluated by an orthopedist using the Harris scale at 6 months postoperatively [ 17 ]. Breast shape satisfaction was defined as the proportion of excellent and good grades.…”