Assessment of Breast Aesthetics

Abstract

A good aesthetic outcome is an important endpoint of breast cancer treatment. Subjective ratings, direct physical measurements, measurements on photographs, and assessment by three-dimensional imaging are reviewed and future directions in aesthetic outcome measurements are discussed. Qualitative, subjective scales have frequently been used to assess aesthetic outcomes following breast cancer treatment. However, none of these scales has achieved widespread use because they are typically vague and have low intraobserver and interobserver agreement. Anthropometry is not routinely performed because conducting the large studies needed to validate anthropometric measures (i.e., studies in which several observers measure the same subjects multiple times) is impractical. Quantitative measures based on digital/digitized photographs have yielded acceptable results but have some limitations. Three-dimensional imaging has the potential to enable consistent, objective assessment of breast appearance, including properties (e.g., volume) that are not available from two-dimensional images. However, further work is needed to define three-dimensional measures of aesthetic properties and how they should be interpreted.

Escala para avaliação de resultados de cirurgia estética do abdome

“…A confiabilidade destes métodos é inaceitável, segundo Kim et al 9 , para quem escalas globais sofrem devido à terminologia vaga, apontando a necessidade de medidas separadas para diferentes fatores (itens) da avaliação estética, a fim de que os resultados sejam mais fidedignos.…”

“…Volume do abdome o exame físico, sendo aceitáveis tanto imagens impressas quanto apresentadas em um monitor de computador, sendo inclusive essa forma menos invasiva para a paciente 9,10 . A soma da avaliação dos cinco aspectos da presente escala, que pode variar de zero a 10 pontos, expressa de forma mais padronizada e objetiva o grau de satisfação do avaliador com a aparência estética do abdome, seja este avaliador a própria paciente ou o profissional.…”

A Pilot Study on Using Eye Tracking to Understand Assessment of Surgical Outcomes from Clinical Photography

“…It would also be interesting to investigate the relationship between image perception as measured by eye tracking and body image as measured by survey instruments. Eye tracking would be a valuable addition to current methods for evaluating surgical outcomes, such as observer rating scales, and analysis of 2D and 3D images [3]. Growth in the use of the eye-tracking technology in clinical assessment will continue as the technology becomes increasingly more affordable, less invasive, and easier to use.…”

“…The goal of breast reconstruction is to recreate a breast form that is satisfying to the patient, facilitating her psychosocial adjustment to living as a breast cancer survivor. Currently, physicians, patients, or other observers evaluate characteristics of the reconstructed breasts, such as symmetry and proportion, in a subjective, qualitative manner [3]. However, such assessments are typically based on vaguely defined rating scales that have low intra-and inter-observer agreement.…”

Multi-view stereophotogrammetry for post-mastectomy breast reconstruction

“…Current breast cancer treatment encompasses not only surgical removal of the tumor and medical adjuvant and neo-adjuvant therapies, but also an increasing emphasis lies on improving of a woman's quality of life [2]. Breast reconstruction plays an important role to restore breast symmetry following partial and total mastectomy procedures that result in abnormal volume, shape, and contours of breast with the aim of creating aesthetically pleasing and symmetrical breasts [3]. The conduct of breast reconstruction procedures currently remains largely subjective and is based on physical examination and visual-estimates of breast size, shape and symmetry.…”