title: Factors determining esthetic outcome after breast cancer conservative treatment.
abstract: The aim of this study was to evaluate the factors that determine esthetic outcome after breast cancer conservative treatment, based on a consensual classification obtained with an international consensus panel. Photographs were taken from 120 women submitted to conservative unilateral breast cancer surgery (with or without axillary surgery) and radiotherapy. The images were sent to a panel of observers from 13 different countries and consensus on the classification of esthetic result (recorded as excellent, good, fair or poor) was obtained in 113 cases by means of a Delphi method. For each patient, data were collected retrospectively regarding patient characteristics, tumor, and treatment factors. Univariate and multivariate analysis were used to evaluate the correlation between these factors and overall cosmetic results. On univariate analysis, younger and thinner patients as well as patients with lower body mass index (BMI) and premenopausal status obtained better cosmetic results. In the group of tumor- and treatment-related factors, larger removed specimens, clearly visible scars, the use of chemotherapy and longer follow-up period were associated with less satisfactory results. On multivariate analysis, only BMI and scar visibility maintained a significant association with cosmesis. BMI and scar visibility are the only factors significantly associated with cosmetic results of breast cancer conservative treatment, as evaluated by an international consensus panel.
authors.affiliation: Serviço de Cirurgia, Hospital S. João, Faculdade de Medicina do Porto, Porto, Portugal. mjcard@mail.med.up.pt
authors.forename: Maria J
authors.initials: MJ
authors.lastname: Cardoso
authors.forename: Jaime
authors.initials: J
authors.lastname: Cardoso
authors.forename: Ana C
authors.initials: AC
authors.lastname: Santos
authors.forename: Conny
authors.initials: C
authors.lastname: Vrieling
authors.forename: David
authors.initials: D
authors.lastname: Christie
authors.forename: Göran
authors.initials: G
authors.lastname: Liljegren
authors.forename: Isabel
authors.initials: I
authors.lastname: Azevedo
authors.forename: Jørgen
authors.initials: J
authors.lastname: Johansen
authors.forename: José
authors.initials: J
authors.lastname: Rosa
authors.forename: Natália
authors.initials: N
authors.lastname: Amaral
authors.forename: Rauni
authors.initials: R
authors.lastname: Saaristo
authors.forename: Virgilio
authors.initials: V
authors.lastname: Sacchini
authors.forename: Henrique
authors.initials: H
authors.lastname: Barros
authors.forename: Manuel C
authors.initials: MC
authors.lastname: Oliveira
mesh_terms: D001291:Attitude of Health Personnel; D015992:Body Mass Index; D001943:Breast Neoplasms / Q000601:surgery*; D002921:Cicatrix / Q000473:pathology; D003697:Delphi Technique; D004954:Esthetics; D005260:Female; D006801:Humans; D008297:Male; D015412:Mastectomy, Segmental; D008875:Middle Aged; D015999:Multivariate Analysis; D010781:Photography