Objective Measurement of Cosmetic Outcomes of Breast Conserving Therapy Using BCCT.core

Abstract

PurposeThe purpose of this study is to evaluate objective cosmetic outcomes and factors related to breast-conserving therapy (BCT) using the BCCT.core software.Materials and MethodsFifty-one patients who received BCT with informed consent were evaluated using the BCCT.core software. Patients were divided into two groups based on the BCCT score: excellent or good (n=42) vs. fair or poor (n=9). Analysis of clinical factors was performed to determine factors affecting cosmetic outcomes.ResultsThe objective cosmetic outcome of BCT measured using the BCCT.core software was excellent in 10% of patients, good in 72%, and fair in 18%. None of the patients were classified as poor outcome. Tumor characteristics, systemic adjuvant therapy (chemotherapy and hormonal therapy), and radiation dose or energy of electron boost did not show correlation with the score measured by the BCCT.core program (p > 0.05). In univariate analysis, maximum dose within the breast (Dmax), width of tangential field, and excised tumor volume were smaller in patients with excellent or good by the BCCT.core compared to those with fair or poor (Dmax, 110.2±1.5% vs. 111.6±1.7%, p=0.019; width of tangential field, 8.0±1.1 cm vs. 8.6±0.7 cm, p=0.034; excised tumor volume, 64.0±35.8 cm3 vs. 95.3±54.4 cm3, p=0.067). In multivariate analysis, only Dmax was a significant factor for breast cosmetic outcome with a risk ratio of 1.697 (95% confidence interval, 1.006 to 2.863; p=0.047).ConclusionObjective measurement of cosmetic outcome of BCT using the BCCT.core software was feasible. The cosmetic outcome of BCT may be affected by the maximum dose within the breast.

Objective assessment of flap volume changes and aesthetic results after adjuvant radiation therapy in patients undergoing immediate autologous breast reconstruction

“…Cardoso et al [ 18 ] reported that the BCCT-core program was an objective evaluation tool for the evaluation of breast cosmesis. Yu et al [ 19 ] also reported the validity of the BCCT-core program in assessing the outcomes in patients undergoing breast conserving surgery and adjuvant radiation.…”

Evaluación de la asimetría mamaria mediante algoritmos de desplazamiento óptico

“…En varias publicaciones se contrastan los métodos ya existentes con estimaciones subjetivas de simetría, normalmente empleando la escala de Harris por parte de paneles de expertos. (27)(28)(29) . Fitzal y Krois (9,22) validan la última versión de su sistema de dos formas diferentes: por un lado, evalúan las impresiones de un solo observador en una muestra de 50 pacientes frente a la puntuación de su aplicación informática.…”

“…Ocurre lo contrario con los parámetros frente a los que hemos comparado GBAI: la literatura los aplica solamente a casos con cirugía tras cáncer de mama. (29) Nuestro estudio es el primero en evaluar objetivamente la asimetría mamaria en pacientes de Cirugía Estética con BSI, BCCT y OBCSN.…”

“…Todos estos resultados coinciden con los de otros autores en estudios similares. (28,29,33) La valoración subjetiva sigue manteniendo un peso muy relevante en la evaluación del aspecto de las mamas, y es precisamene la subjetividad la primera en evidenciar una asimetría en la percepción de la imagen mamaria. Es bien sabido que estímulos visuales con simetría bilateral son capaces de activar áreas concretas de la corteza visual asociativa.…”

Hasil Kosmetik Pasca Breast Conserving Treatment pada Wanita Indonesia dengan Kanker Payudara Stadium T1-2N0

“…Dalam proses penilaian hasil dari BCT dari segi bedah kosmetik, ada beberapa hal penting yang harus menjadi pertimbangan [10][11][12][13][14][15]…”