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A Prospective Study of Cosmetic Outcomes for Patients Treated with Breast Conservation and Radiation Therapy using Shorter Fractionation Schedules at Auckland Hospital, New Zealand.
- Source :
-
Clinical Oncology . Apr2020, Vol. 32 Issue 4, p221-227. 7p. - Publication Year :
- 2020
-
Abstract
- Breast cosmesis is an important outcome for women after breast conservation. It has been shown to be correlated with better patient satisfaction, sexuality and self-esteem. This study reports the subjective and objective breast cosmesis outcomes for women treated at Auckland Hospital Radiation Oncology Department using hypofractionated radiation therapy. Breast cosmesis was evaluated using a subjective questionnaire and standardised photographs before radiation, at 6 weeks, 1 year, 3 years and 5 years after radiation. Objective evaluation of the photographs and completion of questionnaires were undertaken by clinicians at the same time points. The questionnaire evaluated global cosmesis on a four-point scale – excellent (E), good (G), fair (F) and poor (P). Patient, tumour and treatment factors were evaluated to assess the impact on cosmesis. Three hundred and fifty-eight patients completed the baseline assessments and two hundred and two patients completed the 5-year assessments. Sixty-eight per cent of patients at baseline and 70% at 5 years scored their cosmesis as E/G compared with 52% and 51%, respectively, by clinician assessment. Age >50 years, separation ≤25 cm, non-diabetic, T1 tumours, node negative, quadrant of the scar, no boost and no adjuvant endocrine therapy were correlated with E/G cosmesis. On multivariate analysis at baseline, the individual breast factors that were significantly associated with a score of E/G cosmesis were breast shape (P = 0.028) and scar appearance (P = 0.001). At 5 years, breast shape (P = 0.003), nipple shape (P = 0.019) and scar appearance (P = 0.001) were found to be significant. This study shows that most women reported no significant change in their breast cosmesis after hypofractionated radiation treatment over 5 years and that a number of patient, tumour and treatment factors may impact on breast cosmesis. • 70% of patients report excellent/good cosmesis after hypofractionated radiation. • Factors affecting cosmesis include: • Patient age >50 years, separation ≤25 cm, non-diabetic. • Tumour size and node negative. • Surgical scar position, radiation dosimetry, no boost. [ABSTRACT FROM AUTHOR]
- Subjects :
- *EVALUATION of photographs
*AESTHETICS
*AGE distribution
*ATTITUDE (Psychology)
*PERSONAL beauty
*BODY image
*BREAST
*BREAST tumors
*CANCER patients
*COMPARATIVE studies
*DIABETES
*HEALTH facilities
*LONGITUDINAL method
*MEDICAL personnel
*MULTIVARIATE analysis
*ONCOLOGY
*PATIENT satisfaction
*QUESTIONNAIRES
*RADIATION doses
*RADIOTHERAPY
*SCARS
*PLASTIC surgery
*WOMEN'S health
*DEPARTMENTS
*LUMPECTOMY
*TREATMENT effectiveness
*PRE-tests & post-tests
*PATIENTS' attitudes
*DESCRIPTIVE statistics
*EVALUATION
Subjects
Details
- Language :
- English
- ISSN :
- 09366555
- Volume :
- 32
- Issue :
- 4
- Database :
- Academic Search Index
- Journal :
- Clinical Oncology
- Publication Type :
- Academic Journal
- Accession number :
- 142004733
- Full Text :
- https://doi.org/10.1016/j.clon.2019.10.003