THE COSMETIC OUTCOME OF BREAST RECONSTRUCTION

REPRODUCIBILITY OF DIFFERENT METHODS ASSESSED BY DIFFERENT PROFESSIONALS

Authors

Keywords:

breast neoplasms, reconstructive surgical procedures, surgery, plastic

Abstract

Objective: To compare the reproducibility of different methods for assessing the cosmetic outcome of breast reconstruction, which was assessed by different health professionals. Methods: Photographs of 270 breast cancer patients who had been submitted to breast reconstruction of some type were included. A plastic surgeon, a resident in plastic surgery, two mastologists, two residents in mastology, and two psychologists performed the evaluation. The modified Garbay and Harvard scales and the objective BCCT. core software program were used. Cohen’s Kappa and Spearman correlation coefficients were calculated. Results: The mean age of the patients was 55.7 (±11.1) years. Overall, 145 women (53.7%) underwent partial breast reconstruction and 125 (46.3%), total breast reconstruction. The mean follow-up time was 63.7±45.6 months. By applying the Harvard scale, the interobserver reproducibility among the different professionals was minimal; whereas the Garbay scale had no agreement. The correlations between the BCCT.core software program and the Harvard and modified Garbay scales were moderate. Conclusion: Correlations between both the modified Garbay scale and the Harvard scale and the objective (BCCT.core) test were moderate. There was less interobserver variability with the Harvard scale compared to the modified Garbay scale.

Downloads

Download data is not yet available.

Author Biographies

Ruffo Freitas-Junior, Universidade Federal de Goiás

Program of Mastology, Department of Obstetrics and Gynecology, Teaching Hospital, Universidade Federal de Goiás

Hugo Andrade Bayeh, Universidade Federal de Goiás

Program of Mastology, Department of Obstetrics and Gynecology, Teaching Hospital, Universidade Federal de Goiás

Regis Resende Paulinelli, Universidade Federal de Goiás

Program of Mastology, Department of Obstetrics and Gynecology, Teaching Hospital, Universidade Federal de Goiás

Leonardo Ribeiro Soares, Universidade Federal de Goiás

Program of Mastology, Department of Obstetrics and Gynecology, Teaching Hospital, Universidade Federal de Goiás

Ana-Carolina Lagos Prates, Universidade Federal de Goiás

Program of Mastology, Department of Obstetrics and Gynecology, Teaching Hospital, Universidade Federal de Goiás

Pauline Camargo Morais, Universidade Federal de Goiás

Program of Mastology, Department of Obstetrics and Gynecology, Teaching Hospital, Universidade Federal de Goiás

Izabela Cristina Souza de Albuquerque, Universidade Federal de Goiás

Program of Mastology, Department of Obstetrics and Gynecology, Teaching Hospital, Universidade Federal de Goiás

Aloisio Garcia Souza, Universidade Federal de Goiás

Program of Mastology, Department of Obstetrics and Gynecology, Teaching Hospital, Universidade Federal de Goiás

References

Freitas-Junior R, Gagliato DM, Moura Filho JW, Gouveia PA, Rahal RMS, Paulinelli RR, et al. Trends in breast cancer surgery at Brazil’s public health system. J Surg Oncol. 2017;115(5):544- 9. https://doi.org/10.1002/jso.24572

Weber WP, Soysal SD, El-Tamer M, Sacchini V, Knauer M, Tausch C, et al. First international consensus conference on standardization of oncoplastic breast conserving surgery. Breast Cancer Res Treat. 2017;165(1):139-49. https://doi.org/10.1007/s10549-017-4314-5

Cardoso JS, Cardoso MJ. Towards an intelligent medical system for the aesthetic evaluation of breast cancer conservative treatment. Artif Intell Med. 2007;40(2):115-26. https://doi.org/10.1016/j.artmed.2007.02.007

Garbay JR, Rietjens M, Petit JY. Esthetic results of breast reconstruction after amputation for cancer. 323 cases. J Gynecol Obstet Biol Reprod (Paris). 1992;21(4):405-12.

Harris JR, Levene MB, Svensson G, Hellman S. Analysis of cosmetic results following primary radiation therapy for stages I and II carcinoma of the breast. Int J Radiat Oncol Biol Phys. 1979;5(2):257-61. https://doi.org/10.1016/0360-3016(79)90729-6

Leonardi MC, Garusi C, Santoro L, Dell’Acqua V, Rossetto F, Didier F, et al. Impact of medical discipline and observer gender on cosmetic outcome evaluation in breast reconstruction using transverse rectus abdominis myocutaneous (TRAM) flap and radiotherapy. J Plast Reconstr Aesthet Surg. 2010;63(12):2091-7. https://doi.org/10.1016/j.bjps.2010.02.013

Cardoso MJ, Cardoso J, Santos AC, Barros H, Cardoso de Oliveira M. Interobserver agreement and consensus over the esthetic evaluation of conservative treatment for breast cancer. Breast. 2006;15(1):52-7. https://doi.org/10.1016/j.breast.2005.04.013

Preuss J, Lester L, Saunders C. BCCT.core - can a computer program be used for the assessment of aesthetic outcome after breast reconstructive surgery? Breast. 2012;21(4):597- 600. https://doi.org/10.1016/j.breast.2012.05.012

Cardoso MJ, Cardoso JS, Oliveira HP, Gouveia P. The breast cancer conservative treatment. Cosmetic results - BCCT. core - Software for objective assessment of esthetic outcome in breast cancer conservative treatment: A narrative review. Comput Methods Programs Biomed. 2016;126:154-9. https://doi.org/10.1016/j.cmpb.2015.11.010

Urban C. Rietjens M (eds.). Oncoplastic and reconstructive breast surgery. Milan: Springer, 2013.

Rose MA, Olivotto I, Cady B, Koufman C, Osteen R, Silver B, et al. Conservative surgery and radiation therapy for early breast cancer. Long-term cosmetic results. Arch Surg. 1989;124(2):153- 7. https://doi.org/10.1001/archsurg.1989.01410020023002

Wachter T, Edlinger M, Foerg C, Djedovic G, Mayerl C, Kinzl J, et al. Differences between patients and medical professionals in the evaluation of aesthetic outcome following breast reconstruction with implants. J Plast Reconstr Aesthet Surg. 2014;67(8):1111-7. https://doi.org/10.1016/j.bjps.2014.04.004

Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics. 1977;33(1):159-74.

Evans JD. Straightforward Statistics for the Behavioral Sciences. Pacific Grove, CA: Brooks/Cole Publishing; 1996.

Cardoso MJ, Cardoso J, Amaral N, Azevedo I, Barreau L, Bernardo M, et al. Turning subjective into objective: the BCCT. core software for evaluation of cosmetic results in breast cancer conservative treatment. Breast. 2007;16(5):456-61. https://doi.org/10.1016/j.breast.2007.05.002

Casella D, Di Taranto G, Marcasciano M, Sordi S, Kothari A, Kovacs T, et al. Nipple-sparing bilateral prophylactic mastectomy and immediate reconstruction with TiLoop® Bra mesh in BRCA1/2 mutation carriers: A prospective study of long-term and patient reported outcomes using the BREAST-Q. Breast. 2018;39:8-13. https://doi.org/10.1016/j.breast.2018.02.001

Santos G, Urban C, Edelweiss MI, Zucca-Matthes G, de Oliveira VM, Arana GH, et al. Long-Term Comparison of Aesthetical Outcomes After Oncoplastic Surgery and Lumpectomy in Breast Cancer Patients. Ann Surg Oncol. 2015;22(8):2500-8. https://doi.org/10.1245/s10434-014- 4301-6

Ho PJ, Hartman M, Young-Afat DA, Gernaat SAM, Lee SC, Verkooijen HM. Determinants of satisfaction with cosmetic outcome in breast cancer survivors: A cross-sectional study. PLoS One. 2018;13(2):e0193099. https://doi.org/10.1371/journal.pone.0193099

Wijgman DJ, Ten Wolde B, van Groesen NR, Keemers-Gels ME, van den Wildenberg FJ, Strobbe LJ, et al. Short term safety of oncoplastic breast conserving surgery for larger tumors. Eur J Surg Oncol. 2017;43(4):665-71. https://doi. org/10.1016/j.ejso.2016.11.021

Ojala K, Meretoja TJ, Leidenius MH. Aesthetic and functional outcome after breast conserving surgery - Comparison between conventional and oncoplastic resection. Eur J Surg Oncol. 2017;43(4):658-64. https://doi.org/10.1016/j.ejso.2016.11.019

Olsen MA, Nickel KB, Fox IK, Margenthaler JA, Wallace AE, Fraser VJ. Comparison of Wound Complications After Immediate, Delayed, and Secondary Breast Reconstruction Procedures. JAMA Surg. 2017;152(9):e172338. https://doi.org/10.1001/jamasurg.2017.2338

Andrades P, Fix RJ, Danilla S, Howell RE 3rd, Campbell WJ, De la Torre J, et al. Ischemic complications in pedicle, free, and muscle sparing transverse rectus abdominis myocutaneous flaps for breast reconstruction. Ann Plast Surg. 2008;60(5):562- 7. https://doi.org/10.1097/SAP.0b013e31816fc372

Chirappapha P, Somintara O, Lertsithichai P, Kongdan Y, Supsamutchai C, Sukpanich R, et al. Complications and oncologic outcomes of pedicled transverse rectus abdominis myocutaneous flap in breast cancer patients. Gland Surg. 2016;5(4):405-15. https://dx.doi.org/10.21037%2Fgs.2016.07.01

Soares PCM, Pires DM, Medeiros CM. The standardization of photographic records for oncoplastic and breast reconstructive surgery. Mastology. 2017;27(4):352-8. https://dx.doi.org/10.29289/2594539420170000248

Downloads

Published

2019-10-09

How to Cite

Freitas-Junior, R., Bayeh, H. A., Paulinelli, R. R., Soares, L. R., Prates, A.-C. L., Morais, P. C., … Beloti, T. R. (2019). THE COSMETIC OUTCOME OF BREAST RECONSTRUCTION: REPRODUCIBILITY OF DIFFERENT METHODS ASSESSED BY DIFFERENT PROFESSIONALS. Mastology, 29(4), 173–179. Retrieved from https://revistamastology.emnuvens.com.br/revista/article/view/602

Issue

Section

Original Articles