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Breast‐specific factors determine cosmetic outcome and patient satisfaction after breast‐conserving therapy: Results from the randomized COBALT study
Author(s) -
Volders José H.,
Negenborn Vera L.,
Haloua Max H.,
Krekel Nicole M.A.,
Jóźwiak Katarzyna,
Meijer Sybren,
van den Tol Petrousjka M.
Publication year - 2018
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.25012
Subject(s) - cosmesis , medicine , patient satisfaction , breast cancer , likert scale , randomized controlled trial , surgery , physical therapy , cancer , statistics , mathematics
Background and Objectives To identify breast‐specific factors and the role of tumor, treatment, and patient‐related items in influencing patient opinion on cosmesis and satisfaction after breast‐conserving therapy (BCT). Methods Data from the randomized COBALT study was used. At 3, 12, and 36 months, 128 patients with T1‐T2 breast cancer completed a questionnaire on breast‐specific factors and overall cosmetic outcome and patient satisfaction, using a 4‐point Likert scale. Results There was a strong positive correlation between breast‐specific factors, overall cosmetic outcome,and satisfaction at all time‐points. Excellent/good cosmetic outcomes and satisfaction decreased during follow‐up. A shift was noted in the degree of influence of the various breast‐specific factors. At 3 years, symmetry factors such as size, shape, and nipple position largely determined a patient's opinion on the final cosmesis, followed by firmness. The risk of an unacceptable outcome was associated with young age and large excision volumes. Conclusion A questionnaire including breast‐specific questions provides important information on final cosmetic results and satisfaction after BCT. These outcomes can also be of great value as quality indicators and pre‐operative counseling. The major influence of breast‐specific factors on asymmetry underlines the importance of achieving an optimal excision volume at the initial procedure.