title: Prospective study validating inter- and intraobserver variability of tissue compliance meter in breast tissue of healthy volunteers: potential implications for patients with radiation-induced fibrosis of the breast.
abstract: OBJECTIVE
  Accurate detection of radiation-induced fibrosis (RIF) is crucial in management of breast cancer survivors. Tissue compliance meter (TCM) has been validated in musculature. We validate TCM in healthy breast tissue with respect to interobserver and intraobserver variability before applying it in RIF.
  
  
  METHODS
  Three medical professionals obtained three consecutive TCM measurements in each of the four quadrants of the right and left breasts of 40 women with no breast disease or surgical intervention. The intraclass correlation coefficient (ICC) assessed interobserver variability. The paired t test and Pearson correlation coefficient (r) were used to assess intraobserver variability within each rater.
  
  
  RESULTS
  The median age was 45 years (range, 24-68 years). The median bra size was 35C (range, 32A-40DD). Of the participants, 27 were white (67%), 4 black (10%), 5 Asian (13%), and 4 Hispanic (10%). ICCs indicated excellent interrater reliability (low interobserver variability) among the three raters, by breast and quadrant (all ICC ≥ 0.99). The paired t test and Pearson correlation coefficient both indicated low intraobserver variability within each rater (right vs. left breast), stratified by quadrant (all r ≥ 0.94, p < 0.0001).
  
  
  CONCLUSIONS
  The interobserver and intraobserver variability is small using TCM in healthy mammary tissue. We are now embarking on a prospective study using TCM in women with breast cancer at risk of developing RIF that may guide early detection, timely therapeutic intervention, and assessment of success of therapy for RIF.
authors.affiliation: Stich Radiation Oncology, Weill Cornell Medical College of Cornell University, New York, NY 10065, USA. gaw9008@med.cornell.edu
authors.forename: A Gabriella
authors.initials: AG
authors.lastname: Wernicke
authors.forename: Bhupesh
authors.initials: B
authors.lastname: Parashar
authors.forename: Fridon
authors.initials: F
authors.lastname: Kulidzhanov
authors.forename: Lillian
authors.initials: L
authors.lastname: Riley
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Christos
authors.forename: Andrew
authors.initials: A
authors.lastname: Fischer
authors.forename: Dattatreyudu
authors.initials: D
authors.lastname: Nori
authors.forename: K S Clifford
authors.initials: KS
authors.lastname: Chao
mesh_terms: D000328:Adult; D000368:Aged; D001940:Breast / Q000033:anatomy & histology* / Q000473:pathology / Q000528:radiation effects; D003187:Compliance / Q000502:physiology*; D019719:Diagnostic Equipment; D005260:Female; D005355:Fibrosis; D006801:Humans; D008875:Middle Aged; D015588:Observer Variation; D011446:Prospective Studies; D011832:Radiation Injuries / Q000473:pathology; D055815:Young Adult
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