Cosmetic Outcomes and Complications Reported by Patients Having Undergone Breast-Conserving Treatment

Hill‐Kayser, Christine; Vachani, Carolyn; Hampshire, Margaret K.; Lullo, Gloria A. Di; Metz, James M.

doi:10.1016/j.ijrobp.2011.08.013

Cited by 60 publications

(42 citation statements)

References 18 publications

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“…However, up to 30% of women report ''fair'' or ''poor'' cosmesis. 2 There is no uniformly accepted evaluation tool to assess cosmetic outcome as cosmesis is an inherently difficult construct to measure. Cosmetic evaluation can be done by patients, lay persons, or trained observers such as physicians and researchers.…”

mentioning

confidence: 99%

A cosmesis outcome substudy in a prospective, randomized trial comparing radioguided seed localization with standard wire localization for nonpalpable, invasive, and in situ breast carcinomas

Parvez

Cornacchi

Hodgson

et al. 2014

The American Journal of Surgery

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mentioning

confidence: 99%

A cosmesis outcome substudy in a prospective, randomized trial comparing radioguided seed localization with standard wire localization for nonpalpable, invasive, and in situ breast carcinomas

Parvez

Cornacchi

Hodgson

et al. 2014

The American Journal of Surgery

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“…15 As a result of the lack of patient reported cosmesis outcomes following breast conserving therapy, Hill-Kaiser et al performed a web-based survey of patients treated with breast conservation and described the data as the “first assessment of patient-reported cosmetic outcome after BCT”. 16 This survey yielded good-excellent cosmesis ratings in 71% of 331 patients at a median time of 3.6 years after diagnosis. The data presented here provides mature patient reported outcomes related to breast conserving therapy, specifically multicatheter brachytherapy, obtained through a prospective clinical trial.…”

Section: Discussionmentioning

confidence: 96%

RTOG 95-17, a Phase II trial to evaluate brachytherapy as the sole method of radiation therapy for Stage I and II breast carcinoma—year-5 toxicity and cosmesis

et al. 2014

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Introduction RTOG 95-17, a Phase II trial to evaluate multicatheter brachytherapy (mCathBrachy) as the sole method of radiation therapy (RT) for Stage I-II breast cancer (BrCa), was the first cooperative group trial in North America to evaluate accelerated partial breast irradiation (APBI) and include patient reported outcomes (PROs). This report presents year-5 toxicity and cosmesis data. Methods Following lumpectomy and axillary dissection for invasive BrCa (tumor size <3 cm with 0-3 positive lymph nodes), 100 patients (pts), 98 evaluable, were treated (txed) with mCathBrachy from 1997-2000 with 34 Gy in 10 BID high dose-rate fractions or 45 Gy in 3.5-6 days as a low dose-rate implant to 1-2 cm beyond the lumpectomy bed. PROs and physician reported outcomes of toxicity, cosmesis and tx satisfaction at year-5 are reported here, defined as data submitted 54-78 months after tx. Results Grade (G) 1-2 skin toxicity developed in 78% of pts and G3 in 13% (no G4). Tx effects included skin dimpling/indentation (37%), fibrosis (45%), telangiectasias (45%), skin catheter marks (54%), and symptomatic fat necrosis (15%). Breast asymmetry was reported in 73%. Rates of excellent-good cosmesis were similar between PROs (66%) and radiation oncologists (68%). PROs of tx satisfaction at year-5 was 75%. Conclusion RTOG 95-17 documents year-5 skin toxicity and tx effects of mCathBrachy APBI which are associated with PROs of good-excellent cosmesis and high tx satisfaction. This emphasizes the importance of PROs when assessing BrCa tx. NSABP B39/RTOG 0413 will allow for definitive comparisons between APBI and whole breast RT.

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“…Most published papers discuss postoperative morbidity only in terms of evaluating locoregional recurrence. Cosmetic results are often insufficiently evaluated by a group of physicians, retrospectively from physician documentation [28,29] or by simple non-standardized questionnaires that rate the cosmetic results as excellent, good, fair or poor [30]. …”

Section: Discussionmentioning

confidence: 99%

Centrifugation versus PureGraft for fatgrafting to the breast after breast-conserving therapy

et al. 2014

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BackgroundBreast-conserving treatment (BCT) leads to a progressive and deteriorating breast deformity. Fatgrafting is ideal for breast reconstruction after BCT. The most frequently utilized technique for fat processing is centrifugation. The PureGraft device (Cytori Therapeutics, San Diego, CA, USA) is a new method that involves washing and filtering the fat to prepare the graft. We compared the subjective and objective outcomes of two fat-processing methods, centrifugation and PureGraft filtration.MethodsThirty patients underwent breast reconstruction performed by a single surgeon (OM) after BCT in our department between April 2011 and September 2012. The patients were preoperatively divided into two groups randomly: 15 received fatgrafts processed by centrifugation, and 15 received fatgrafts processed by washing in PureGraft bags. The patients were followed up for 12 to 30 months. To measure the subjective outcome, we distributed the BREAST-Q questionnaire to all the patients both preoperatively and 1 year postoperatively. The BCCT.core software evaluated the objective outcome of breast reconstruction by fatgrafting.ResultsThe Breast-Q results indicated a tremendous improvement in the modules “Satisfaction with Breast” and “Psychosocial Well-being”. The “Sexual Well-being” scale also improved. Only the module “Satisfaction with Breasts” significantly differed between groups; patients treated with the PureGraft fat exhibited better outcomes. The BCCT.core results did not significantly differ between the groups.ConclusionOne year postoperatively, the outcomes of the use of PureGraft bags or centrifugation to process fat for breast reconstruction after BCT did not differ. The unpredictability of the results following fatgrafting procedures is likely due to interindividual differences with yet-undisclosed causes.

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Cosmetic Outcomes and Complications Reported by Patients Having Undergone Breast-Conserving Treatment

Cited by 60 publications

References 18 publications

A cosmesis outcome substudy in a prospective, randomized trial comparing radioguided seed localization with standard wire localization for nonpalpable, invasive, and in situ breast carcinomas

A cosmesis outcome substudy in a prospective, randomized trial comparing radioguided seed localization with standard wire localization for nonpalpable, invasive, and in situ breast carcinomas

RTOG 95-17, a Phase II trial to evaluate brachytherapy as the sole method of radiation therapy for Stage I and II breast carcinoma—year-5 toxicity and cosmesis

Centrifugation versus PureGraft for fatgrafting to the breast after breast-conserving therapy

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