Cosmetic outcome of breast conservative treatment for early stage breast cancer

ABSTRACT

Purpose. To evaluate the cosmetic outcome of breastconservative therapy and to examine the degree ofagreement between the patients’ and oncologists’ratings. We also analyze the influence of severalfactors on cosmesis.Methods and materials.We retrospectively evaluated145 patients with primary breast cancer treatedby local excision and radiotherapy between January2000 and May 2001. Cosmetic outcome wasevaluated by doctors and patients and was scoredas excellent, good, fair or poor.Results. 73% of patients rated cosmesis as excellentor good while the percentage was 71% when ratedby radiation oncologists. The degree of cosmesisconcordance evaluated by oncologists and patientswas low (kappa = 0.3). In our study the variableswhich significantly influence on the cosmetic outcomewere concomitant adjuvant chemotherapy(p = 0.04) and radiation therapy boost, either byelectron beam or brachytherapy (p = 0.013).Conclusion. The cosmetic outcome of breast conservingtherapy was good. There was a similar ratingby the patient and radiation oncologist, but thelevel of concordance between patients and doctorswas low. Factors that significantly influence thecosmesis appear to be concomitant adjuvant chemotherapyand radiation therapy boost

RESUMEN

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