Cosmetic outcome of breast conservative treatment for early stage breast cancer.
OBJECTIVE
To evaluate the cosmetic outcome of breast conservative therapy and to examine the degree of agreement between the patients' and oncologists' ratings. We also analyze the influence of several factors on cosmesis.


METHODS
We retrospectively evaluated 145 patients with primary breast cancer treated by local excision and radiotherapy between January 2000 and May 2001. Cosmetic outcome was evaluated by doctors and patients and was scored as excellent, good, fair or poor.


RESULTS
73% of patients rated cosmesis as excellent or good while the percentage was 71% when rated by radiation oncologists. The degree of cosmesis concordance evaluated by oncologists and patients was low (kappa = 0.3). In our study the variables which significantly influence on the cosmetic outcome were concomitant adjuvant chemotherapy (p = 0.04) and radiation therapy boost, either by electron beam or brachytherapy (p = 0.013).


CONCLUSIONS
The cosmetic outcome of breast conserving therapy was good. There was a similar rating by the patient and radiation oncologist, but the level of concordance between patients and doctors was low. Factors that significantly influence the cosmesis appear to be concomitant adjuvant chemotherapy and radiation therapy boost.
Arenas
M
M
Oncology Department, Hospital Universitari Sant Joan de Reus, Catalonia, Spain. marenas@grupsagessa.com
Sabater
S
S
Hernández
V
V
Henríquez
I
I
Ameijide
A
A
Anglada
Ll
L
Mur
E
E
Artigues
M
M
Lafuerza
A
A
Borras
J
J
D000328:Adult; D000368:Aged; D001918:Brachytherapy / Q000523:psychology; D001943:Breast Neoplasms / Q000188:drug therapy / Q000523:psychology / Q000532:radiotherapy / Q000601:surgery*; D017024:Chemotherapy, Adjuvant; D003037:Cobalt Radioisotopes; D003131:Combined Modality Therapy; D004954:Esthetics; D005260:Female; D006801:Humans; D015412:Mastectomy, Segmental / Q000523:psychology; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D010361:Patients / Q000523:psychology*; D017785:Photons; D010820:Physicians / Q000523:psychology*; D018787:Radiation Oncology; D011867:Radioisotope Teletherapy / Q000523:psychology; D018714:Radiotherapy, Adjuvant / Q000523:psychology; D011882:Radiotherapy, High-Energy / Q000523:psychology; D012189:Retrospective Studies
D003037:Cobalt Radioisotopes