title: Factors associated with patient-reported cosmetic outcome in the Young Boost Breast Trial.
abstract: To investigate which factors are related to patient reported cosmetic outcome (PRCO) after breast conserving therapy.
  
  
  
  From 2004 to 2011, 2421 cT1-2N0-2a breast cancer patients were randomised in the Young Boost Trial between a 16 and a 26Gy boost to the tumour bed. Cosmesis was scored subjectively by the patient and physician, and objectively using BCCT.core, at baseline, one and four years after treatment. Presence of fibrosis, QoL and rib pain at four years were also scored. Data were complete for 864 patients. The relation between the separate components was investigated using a proportional odds model.
  
  
  
  Of the 7 BCCT.core parameters, the distance from nipple to inframammary fold and the length of the breast contour were significantly related to the overall PRCO at four years. Patients with more fibrosis and poorer QoL scored their cosmesis worse, while rib pain was not related. The agreement between the different scores was low (kappa 0.26-0.42).
  
  
  
  The distance from nipple to inframammary fold, the length of the breast contour and the severity of fibrosis were the main factors related to patient-reported cosmetic outcome. Patients with better QoL scored their cosmesis better.
authors.affiliation: Department of Radiation Oncology, Maastricht University Medical Center, GROW (MAASTRO), The Netherlands. Electronic address: patricia.brouwers@maastro.nl.
authors.forename: Patricia J A M
authors.initials: PJ
authors.lastname: Brouwers
authors.affiliation: Department of Radiation Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands.
authors.forename: Erik
authors.initials: E
authors.lastname: van Werkhoven
authors.affiliation: Department of Radiation Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands.
authors.forename: Harry
authors.initials: H
authors.lastname: Bartelink
authors.affiliation: Department of Radiation Oncology, Institut Curie, UCBG, Paris, France.
authors.forename: Alain
authors.initials: A
authors.lastname: Fourquet
authors.affiliation: Department of Radiation Oncology, Institut Régional du Cancer Val d'Aurelle, UCBG, Montpellier, France.
authors.forename: Claire
authors.initials: C
authors.lastname: Lemanski
authors.affiliation: Department of Radiation Oncology, Maastricht University Medical Center, GROW (MAASTRO), The Netherlands.
authors.forename: Judith
authors.initials: J
authors.lastname: van Loon
authors.affiliation: Department of Radiation Oncology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
authors.forename: John H
authors.initials: JH
authors.lastname: Maduro
authors.affiliation: Department of Radiation Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands.
authors.forename: Nicola S
authors.initials: NS
authors.lastname: Russell
authors.affiliation: Department of Radiation Oncology, Institute Verbeeten, Tilburg, The Netherlands.
authors.forename: Luc J E E
authors.initials: LJ
authors.lastname: Scheijmans
authors.affiliation: The Netherlands Department of Radiation Oncology, Radboud University Medical Center, Nijmegen, The Netherlands.
authors.forename: Dominic A X
authors.initials: DA
authors.lastname: Schinagl
authors.affiliation: Department of Radiation Oncology, Radiotherapiegroep, Arnhem, The Netherlands.
authors.forename: Antonia H
authors.initials: AH
authors.lastname: Westenberg
authors.affiliation: Department of Radiation Oncology, Institute Verbeeten, Tilburg, The Netherlands.
authors.forename: Philip
authors.initials: P
authors.lastname: Poortmans
authors.affiliation: Department of Radiation Oncology, Maastricht University Medical Center, GROW (MAASTRO), The Netherlands.
authors.forename: Liesbeth J
authors.initials: LJ
authors.lastname: Boersma
mesh_terms: D000328:Adult; D001940:Breast / Q000473:pathology*; D001943:Breast Neoplasms / Q000473:pathology / Q000601:surgery*; D004954:Esthetics; D005260:Female; D006801:Humans; D015412:Mastectomy, Segmental; D008875:Middle Aged; D000071066:Patient Reported Outcome Measures; D016896:Treatment Outcome; D055815:Young Adult
keywords: Breast conserving therapy; Cosmetic outcome; Patient reported outcome; Young boost trial; Young patients