The cosmetic outcome in early breast cancer treated with breast conservation.

AIMS To measure the cosmetic outcome of breast-conserving surgery and identify the factors which influence cosmesis. METHODS A total of 254 patients with primary breast cancer treated by wide local excision, with or without radiotherapy, were subjectively assessed for cosmesis by a six-member panel using photographic evaluation and objectively by an independent observer using specific measurement. RESULTS Good to excellent cosmetic results were achieved in 184 (72%) patients on panel subjective assessment and 201 (79%) patients on objective assessment. Good correlation (P<0.001) and agreement were found between the panel's subjective photographic assessment and the objective assessment. The main factors found to affect cosmesis negatively were: medially located tumours; weight of specimen; re-excision procedures; radiotherapy; small breasts and longer scars. CONCLUSION These cosmetic results, combined with a low local recurrence rate following wide local excision, validate the operative method used.

[1]  A. Beckett,et al.  AKUFO AND IBARAPA. , 1965, Lancet.

[2]  S Hellman,et al.  Analysis of cosmetic results following primary radiation therapy for stages I and II carcinoma of the breast. , 1979, International journal of radiation oncology, biology, physics.

[3]  B Fisher,et al.  Five-year results of a randomized clinical trial comparing total mastectomy and segmental mastectomy with or without radiation in the treatment of breast cancer. , 1985, The New England journal of medicine.

[4]  J O Archambeau,et al.  Breast retraction assessment: an objective evaluation of cosmetic results of patients treated conservatively for breast cancer. , 1985, International journal of radiation oncology, biology, physics.

[5]  A. Luini,et al.  Comparison of Halsted mastectomy with quadrantectomy, axillary dissection, and radiotherapy in early breast cancer: long-term results. , 1986, European journal of cancer & clinical oncology.

[6]  D. Altman,et al.  STATISTICAL METHODS FOR ASSESSING AGREEMENT BETWEEN TWO METHODS OF CLINICAL MEASUREMENT , 1986, The Lancet.

[7]  E. van der Schueren,et al.  Cosmetic evaluation of breast conserving treatment for mammary cancer. 1. Proposal of a quantitative scoring system. , 1989 .

[8]  P. Clingan,et al.  Breast appearance and function after breast conserving surgery and radiotherapy. , 1990, Acta oncologica.

[9]  F. Vicini,et al.  Cosmetic results after surgery, chemotherapy, and radiation therapy for early breast cancer. , 1991, International journal of radiation oncology, biology, physics.

[10]  A. Luini,et al.  Quantitative and qualitative cosmetic evaluation after conservative treatment for breast cancer. , 1991, European journal of cancer.

[11]  N. Robert,et al.  Factors influencing cosmetic outcome and complication risk after conservative surgery and radiotherapy for early-stage breast carcinoma. , 1992, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[12]  J R Yarnold,et al.  Cosmetic and functional outcomes of breast conserving treatment for early stage breast cancer. 1. Comparison of patients' ratings, observers' ratings, and objective assessments. , 1992, Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology.

[13]  L. Holmberg,et al.  The cosmetic outcome in early breast cancer treated with sector resection with or without radiotherapy. Uppsala-Orebro Breast Cancer Study Group. , 1993, European journal of cancer.

[14]  E. Touboul,et al.  Early breast cancer: influence of type of boost (electrons vs iridium-192 implant) on local control and cosmesis after conservative surgery and radiation therapy. , 1995, Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology.

[15]  D. Ash,et al.  Seven-year follow-up on 334 patients treated by breast conserving surgery and short course radical postoperative radiotherapy: a report of the Yorkshire Breast Cancer Group. , 1995, Clinical oncology (Royal College of Radiologists (Great Britain)).

[16]  I. Ellis,et al.  Safe selection criteria for breast conservation without radical excision in primary operable invasive breast cancer. , 1995, European journal of cancer.

[17]  A. Weaver,et al.  Conservative therapy of breast cancer. The Mayo Clinic experience. , 1996, American journal of clinical oncology.

[18]  D. Schultz,et al.  The effects of sequence and type of chemotherapy and radiation therapy on cosmesis and complications after breast conservation therapy. , 1996, International journal of radiation oncology, biology, physics.

[19]  Tomas Kron,et al.  A comparison of methods of cosmetic assessment in breast conservation treatment , 1996 .

[20]  A. Rodger,et al.  Cosmesis following complete local excision of breast cancer. , 1997, The Australian and New Zealand journal of surgery.

[21]  R. Blamey,et al.  Patient evaluation of cosmetic outcome after conserving surgery for treatment of primary breast cancer. , 1999, European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology.