Asian Pacific Journal of Cancer Prevention

Asian Pacific Journal of Cancer Prevention (아시아태평양암예방학회)
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Evaluation of Factors Impacting Cosmetic Outcome of Breast Conservative Surgery - a Study in Iran

  • Published : 2015.04.03
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Abstract

Background: Breast conservative surgery (BCS) followed by radiotherapy is the standard approach in management of stage I-II breast cancer. Several factors can affect cosmetic outcomes. The aim of this study was to evaluate the cosmetic results of BCS and influencing factors in the Iranian Breast Cancer Research Center. Materials and Methods: Patients who had undergone BCS were included. Photographs were taken of both breasts of the patients in three aspects and were evaluated by three specialists. The cosmetic scores were calculated based on a standard questionnaire. The data were analyzed using univariate and multivariate regression for relationships between cosmetic scores and clinical data. Results: A total number of 103 patients were included in the study. Mean age and BMI of the patients were $46.8{\pm}8.9$ and $28.1{\pm}3.9$, respectively. Breast cup sizes C and D accounted for 74.7% of the study group. The mean cosmetic score obtained from three referees was 5.72+2.06, consisting of 35.9% excellent-good, 35% moderate, and 29.1% unsatisfactory results. Patient BMI, volume of the resected tissue and breast cup size (D) showed significant correlation with the cosmetic score. On multivariate regression analysis, cosmetic score and BMI (p=0.022,) as well as breast cup size (p=0.040), remained significant. Conclusions: Immediate or delayed symmetrization of the breasts is suggested during breast conservative surgery, meanwhile performing oncoplastic techniques to improve the results significantly. Also it is suggested to discuss anticipation of less satisfactory results with patients having higher BMI and large breast cup size.

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References

  1. Agarwal S, Pappas L, Neumayer L, et al (2014). Effect of breast conservation therapy vs mastectomy on disease-specific survival for early-stage breast cancer. JAMA Surg, 149, 267-74. https://doi.org/10.1001/jamasurg.2013.3049
  2. Abdullah A, Abdullah KL, Yip CH, et al (2013). The decision-making journey of Malaysian women with early breast cancer: A qualitative study. Asian Pac J Cancer Prev, 14, 7143-7. https://doi.org/10.7314/APJCP.2013.14.12.7143
  3. Fortin AJ, Cheang M, Latosinsky S (2006). Cosmetic outcomes following breast conservation therapy: in search of a reliable scale. Breast Cancer Res treat, 100, 65-70. https://doi.org/10.1007/s10549-006-9223-y
  4. Arenas M, Sabater S, Hernandez V, et al.(2006). Cosmetic outcome of breast conservative treatment for early stage breast cancer. Clin Transl Oncol, 8, 334-8. https://doi.org/10.1007/s12094-006-0179-5
  5. Al-Ghazal SK, Fallowfield L, Blamey RW (1999). Patient evaluation of cosmetic outcome after conserving surgery for treatment of primary breast cancer. Eur J Surg Oncol, 25, 344-6. https://doi.org/10.1053/ejso.1999.0654
  6. Al-Ghazal SK, Blamey RW (1999). Cosmetic assessment of breast-conserving surgery for primary breast cancer. Breast, 8, 162-8. https://doi.org/10.1054/brst.1999.0017
  7. Cardoso MJ, Cardoso J, Santos AC, et al (2007). Factors determining esthetic outcome after breast cancer conservative treatment. Breast J, 13, 140-6. https://doi.org/10.1111/j.1524-4741.2007.00394.x
  8. Clarke D, Martinez A, Cox RS (1983). Analysis of cosmetic results and complications in patients with stage I and II breast cancer treated by biopsy and irradiation. Int J Radiat Oncol Biol Phys, 9, 1807-13. https://doi.org/10.1016/0360-3016(83)90348-6
  9. Deutsch M, Flickinger JC (2003). Patient characteristics and treatment factors affecting cosmesis following lumpectomy and breast irradiation. Am J Clin Oncol, 26, 350-3.
  10. Fortin AJ, Cheang M, Latosinsky S (2006). Cosmetic outcomes following breast conservation therapy: in search of a reliable scale. Breast Cancer Res Treat, 100, 65-70. https://doi.org/10.1007/s10549-006-9223-y
  11. Fisher B, Anderson S, Bryant J, et al (2002). Twenty-year follow-up of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer. N Engl J Med, 347, 1233-41. https://doi.org/10.1056/NEJMoa022152
  12. Garofalo R, Borioni R, Garofalo RLL, et al (1992). Radical tumor excision and cosmetic balance in the surgical treatment of breast carcinoma: biquadrantectomy. Biomed Pharmacother, 46, 401-4. https://doi.org/10.1016/0753-3322(92)90044-8
  13. Harris JR, Levene MB, Svensson G, Hellman S (1999). Analysis of cosmetic results following primary radiation therapy for stages I and II carcinoma of the breast. Int J Radiat Oncol Biol Phys, 5, 257-61.
  14. Johansen J, Overgaard J, Rose C, et al (2002). Cosmetic outcome and breast morbidity in breast-conserving treatment--results from the Danish DBCG-82TM national randomized trial in breast cancer. Acta Oncol, 41, 369-80. https://doi.org/10.1080/028418602760169433
  15. Kaviani A,Taslimi Sh, Athari B, et al (2010). The cosmetic results after oncoplastic breast surgery in Iranian women. Tehran University Med J, 68, 213-9.
  16. Kaviani A, Sodagari N, Sheikhbahaei S, et al (2013). From radical mastectomy to breast-conserving therapy and oncoplastic breast surgery: a narrative review comparing oncological result, cosmetic outcome, quality of life, and health economy. ISRN Oncol, 2013, 742462
  17. Liauw, S.H., L.J. Sanfilippo, E. Santoro,(1987). Breast size versus cosmesis and local control in stages I and II breast carcinoma. N Engl J Med, 84, 706-10.
  18. Munshi, S. Kakkar, R. Bhutani, R. et al (2009). Factors influencing cosmetic outcome in breast conservation. Clin Oncol, 21, 285-93, https://doi.org/10.1016/j.clon.2009.02.001
  19. Omranipour R, Alipour S, Hadji M, et al (2014). Two decades of experience with ductal carcinoma in situ of the breast in the Cancer Institute of Tehran, Iran. Asia Pac J Cancer Prev, 15, 2771-6 https://doi.org/10.7314/APJCP.2014.15.6.2771
  20. Rose MA, Olivotto I, Cady B, et al (1989). Conservative surgery and radiation therapy for early breast cancer. Long-term cosmetic results. Arch Surg, 124, 153-7. https://doi.org/10.1001/archsurg.1989.01410020023002
  21. Sun M-Q, Meng A-F, Huang X-E, et al (2013). Comparison of psychological influence on breast cancer patients between breast-conserving surgery and modified radical mastectomy. Asian Pac J Cancer Prev, 14, 149-52. https://doi.org/10.7314/APJCP.2013.14.1.149
  22. Schultze J, Lossl K, Kimmig B (2008). [Cosmetic results after breast conserving carcinoma treatment in patients with intramammarian seromas]. Rontgenpraxis, 56, 169-80. https://doi.org/10.1016/j.rontge.2007.08.001
  23. Sacchini 1, Luini A, Tana S et al (1991). Quantitative and qualitative cosmetic evaluation after conservative treatment for breast cancer. Eur J Cancer, 27, 1395-400. https://doi.org/10.1016/0277-5379(91)90019-A
  24. Tan MP-T, Sitoh NY-Y, Sim AS-T (2014) Evaluation of eligibility and utilization of breast conservation treatment in an Asian context. Asian Pac J Cancer Prev, 15, 4683-4688 https://doi.org/10.7314/APJCP.2014.15.11.4683
  25. Taylor ME, Perez CA, Halverson KJ, et al (1995). Factors influencing cosmetic results after conservation therapy for breast cancer. Int J Radiat Oncol Biol Phys, 31, 753-64. https://doi.org/10.1016/0360-3016(94)00480-3
  26. Touboul E, Belkacemi Y, Lefranc JP, et al. (1995). Early breast cancer:influence of type of boost (electrons vs iridium-192 implant) on local control and cosmesis after conservative surgery and radiation therapy. Radiother Oncol, 34, 105-13. https://doi.org/10.1016/0167-8140(95)01508-E
  27. Veronesi U, Cascinelli N, Mariani L et al (2002). Twenty-year follow-up of a randomized study comparing breast-conserving surgery with radical mastectomy for early breast cancer. N Engl J Med, 347, 1227-32. https://doi.org/10.1056/NEJMoa020989

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