Consistency of patient- and doctor-assessed cosmetic outcome after conservative treatment of breast cancer.
The cosmetic results of the breast (144 patients) were analysed after segmental resection and axillary dissection with or without postoperative radiotherapy for early low-risk breast cancers. Cosmetic results were assessed over time (3, 9, 18, 36, 48 months respectively) by the patient and by the physician. Patients rated the overall cosmetic result good or excellent in 92% of cases after 3 months. The proportion of good or excellent cosmetic results decreased over time and after four years 89% of patients classified themselves in this category, whereas the physician assessed the outcome as good or excellent in 91% of cases after 3 months and 75% after 4 years. The inter-observer consistency between physician and patient in assessing the cosmetic outcome was kappa = 0.42 at the beginning and decreased over time (kappa = 0.07 after 4 years). The intra-observer variation over time was kappa = 0.53 for the patient and kappa = 0.32 for the physician. Inter-observer consistency between patient and physician was moderate immediately following treatment but decreased over time. The feeling of satisfaction of the patient was relatively stable whereas the opinion of the physician became somewhat more critical over time. Therefore the intra-observer consistency over time was somewhat better for the patient than for the physician.
Kaija
H
H
Department of Oncology, University Hospital of Tampere, Finland.
Rauni
S
S
Jorma
I
I
Matti
H
H
D001943:Breast Neoplasms / Q000532:radiotherapy / Q000601:surgery*; D003357:Cosmetic Techniques; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008197:Lymph Node Excision; D015412:Mastectomy, Segmental; D008875:Middle Aged; D009367:Neoplasm Staging