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Long-term objective esthetic outcome after breast-conserving therapy

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Abstract

The prediction of unfavorable long-term esthetic outcome (AO) is important for patient consultation. We aimed to analyze variables characterizing the improvement and impairment of AO over time after breast-conserving surgery. A subgroup of a prospective, monocenter cohort study was analyzed to evaluate the results of the BCCT.core software (Breast Cancer Conservative Treatment.cosmetic results) which was used to objectively assess the AO before (n = 356), shortly after (n = 294) and in median 3 years after surgery (n = 356). We analyzed potential influencing factors (such as body mass index, (y)pT-stage, weight of resected specimen, etc.) on the AO using logistic regression analyses (n = 256). Finally, we tried to characterize groups of patients with improving or impaired AO over time (n = 294). Predictors for an unfavorable AO were an axillary lymphadenectomy (OR = 4.05), a tumor in the 12 o’clock position (OR = 2.22), a tumor stage larger or equal to (y)pT2 stage (OR = 2.11), and a surgical specimen weight >75 g (OR = 2.71). Patients with lower specimen weight were more likely to improve in the long-term follow-up (p = 0.018), whereas patients with a higher (y)pT-stage tended to become impaired with time. Although overall AO decreased over time, nearly half of the patients with an unfavorable AO shortly after surgery improved in the long-term follow-up. Predictors of unfavorable AO can be used in patient consultation preoperatively to prepare them for the postsurgical period and/or to recommend surgical alternatives (e.g., more complex oncoplastic techniques). Knowledge of improvement and impairment may help patients and physicians in the postsurgical consultation setting.

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References

  1. Mitov FS, Molov VV (2006) Breast-conserving surgery in early-stage breast cancer (indications, local recurrences, survival, cosmetic results). Folia Med (Plovdiv) 48(1):23–30

    Google Scholar 

  2. Fowble B et al (1996) The impact of tamoxifen on breast recurrence, cosmesis, complications, and survival in estrogen receptor-positive early-stage breast cancer. Int J Radiat Oncol Biol Phys 35(4):669–677

    Article  CAS  PubMed  Google Scholar 

  3. van Dongen JA et al (2000) Long-term results of a randomized trial comparing breast-conserving therapy with mastectomy: European Organization for Research and Treatment of Cancer 10801 trial. J Natl Cancer Inst 92(14):1143–1150

    Article  PubMed  Google Scholar 

  4. Fisher B et al (2002) Twenty-year follow-up of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer. N Engl J Med 347(16):1233–1241

    Article  PubMed  Google Scholar 

  5. Driul L et al (2013) New surgical trends in breast cancer treatment: conservative interventions and oncoplastic breast surgery. Minerva Ginecol 65(3):289–296

    CAS  PubMed  Google Scholar 

  6. Waljee JF et al (2008) Effect of esthetic outcome after breast-conserving surgery on psychosocial functioning and quality of life. J Clin Oncol 26(20):3331–3337

    Article  PubMed  Google Scholar 

  7. Heil J (2010) Change of aesthetic and functional outcome over time and their relationship to quality of life after breast conserving therapy. Eur J Surg Oncol 37:116

    Article  PubMed  Google Scholar 

  8. Kim MS et al (2008) Assessment of breast aesthetics. Plast Reconstr Surg 121(4):186e–194e

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Andrade WN, Semple JL (2006) Patient self-assessment of the cosmetic results of breast reconstruction. Plast Reconstr Surg 117(1):44–47 discussion 48-9

    Article  CAS  PubMed  Google Scholar 

  10. Al-Ghazal SK, Blamey RW (1999) Cosmetic assessment of breast-conserving surgery for primary breast cancer. Breast 8(4):162–168

    Article  CAS  PubMed  Google Scholar 

  11. Heil J et al (2012) Objective assessment of aesthetic outcome after breast conserving therapy: subjective third party panel rating and objective BCCT.core software evaluation. Breast 21(1):61–65

    Article  PubMed  Google Scholar 

  12. Cardoso MJ (2007) Turning subjective into objective: The BCCT.core software for evaluation of cosmetic results in breast cancer conservative treatment. Breast 16:456

    Article  PubMed  Google Scholar 

  13. Cardoso MJ et al (2009) Comparing two objective methods for the aesthetic evaluation of breast cancer conservative treatment. Breast Cancer Res Treat 116(1):149–152

    Article  PubMed  Google Scholar 

  14. Heil J (2010) Aesthetics in breast conserving therapy: do objectively measured results Match patients’ evaluations. Ann Surg Oncol 18:134

    Article  PubMed  Google Scholar 

  15. Cardoso MJ et al (2012) Recommendations for the aesthetic evaluation of breast cancer conservative treatment. Breast Cancer Res Treat 135(3):629–637

    Article  PubMed  Google Scholar 

  16. Heil J et al (2010) Aesthetic and functional results after breast conserving surgery as correlates of quality of life measured by a German version of the Breast Cancer Treatment Outcome Scale (BCTOS). Breast 19(6):470–474

    Article  PubMed  Google Scholar 

  17. Hoffmann J, Wallwiener D (2009) Classifying breast cancer surgery: a novel, complexity-based system for oncological, oncoplastic and reconstructive procedures, and proof of principle by analysis of 1225 operations in 1166 patients. BMC Cancer 9:108

    Article  PubMed  PubMed Central  Google Scholar 

  18. Wockel A, Kreienberg R (2008) First Revision of the German S3 Guideline ‘Diagnosis, Therapy, and Follow-Up of Breast Cancer’. Breast Care (Basel) 3(2):82–86

    Article  Google Scholar 

  19. Preuss J, Lester L, Saunders C (2012) BCCT.core—can a computer program be used for the assessment of aesthetic outcome after breast reconstructive surgery? Breast 21(4):597–600

    Article  CAS  PubMed  Google Scholar 

  20. Cardoso MJ et al (2008) Is face-only photographic view enough for the aesthetic evaluation of breast cancer conservative treatment? Breast Cancer Res Treat 112(3):565–568

    Article  PubMed  Google Scholar 

  21. Eder M (2011) Objective breast symmetry evaluation using 3-D surface imaging. Breast 21:152

    Article  PubMed  Google Scholar 

  22. Cardoso MJ et al (2007) Factors determining esthetic outcome after breast cancer conservative treatment. Breast J 13(2):140–146

    Article  PubMed  Google Scholar 

  23. Foersterling E et al (2014) Predictors of early poor aesthetic outcome after breast-conserving surgery in patients with breast cancer: initial results of a prospective cohort study at a single institution. J Surg Oncol 110(7):801–806

    Article  PubMed  Google Scholar 

  24. Kelly DA et al (2012) Outcome analysis of 541 women undergoing breast conservation therapy. Ann Plast Surg 68(5):435–437

    Article  CAS  PubMed  Google Scholar 

  25. Wang HT et al (2008) Aesthetic outcomes in breast conservation therapy. Aesthet Surg J 28(2):165–170

    Article  PubMed  Google Scholar 

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Acknowledgments

Prof. Joerg Heil received funding from the German Research Foundation (HE 6824/1-1).

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Authors and Affiliations

  1. University Breast Unit, University Hospital of Heidelberg, Im Neuenheimer Feld 440, 69120, Heidelberg, Germany

    André Hennigs, Benjamin Hartmann, Geraldine Rauch, Michael Golatta, Patrik Tabatabai, Christoph Domschke, Sarah Schott, Florian Schütz, Christof Sohn & Joerg Heil

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  1. André Hennigs
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  2. Benjamin Hartmann
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  3. Geraldine Rauch
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  4. Michael Golatta
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  5. Patrik Tabatabai
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  6. Christoph Domschke
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  7. Sarah Schott
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  8. Florian Schütz
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  9. Christof Sohn
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  10. Joerg Heil
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Correspondence to Joerg Heil.

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The authors declare that they have no conflicts of interest.

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The ethics commission of the University of Heidelberg Medical School approved the study. All patients gave their written consent to participate.

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Hennigs, A., Hartmann, B., Rauch, G. et al. Long-term objective esthetic outcome after breast-conserving therapy. Breast Cancer Res Treat 153, 345–351 (2015). https://doi.org/10.1007/s10549-015-3540-y

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  • DOI: https://doi.org/10.1007/s10549-015-3540-y

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