Determinants of breast reconstruction outcome: How important is volume symmetry?

Yip, Jia Miin; Watson, David I.; Tiggemann, Marika; Hsia, Shawn; Smallman, Andrea; Dean, Nicola R.

doi:10.1016/j.bjps.2014.12.038

Cited by 34 publications

(22 citation statements)

References 33 publications

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“…On the basis of this finding, we may state that women who have their mastectomy, reconstruction and symmetrisation as one single operation may be happier with their outcome 9 and so, less likely to consult the Page 11 of 16 surgeon for revision surgery (whether this is related to the quality of the outcome, patient satisfaction or otherwise is still unknown). In support of this hypothesis, Yip et al (2015) showed that in the context of reconstruction and contralateral symmetrisation, breast volume symmetry was not related to satisfaction but most influenced by the pre-operative care as part of the reconstructive 'process'…”

Section: Resultssupporting

confidence: 51%

Contralateral breast symmetrisation in unilateral DIEP flap breast reconstruction

Wade

Marongiu

Sassoon

et al. 2016

Journal of Plastic, Reconstructive & Aesthetic Surgery

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Section: Resultssupporting

confidence: 51%

Contralateral breast symmetrisation in unilateral DIEP flap breast reconstruction

Wade

Marongiu

Sassoon

et al. 2016

Journal of Plastic, Reconstructive & Aesthetic Surgery

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“…Sub-question ‘How much your breasts look the same’ demonstrated even better association with shape symmetry, with four pairwise comparisons. A similar study was undertaken by Yip et al [39] where 119 women who had undergone immediate or delayed breast reconstruction underwent 3D-SI and answered the BREAST-Q post-operative reconstruction module. Unlike this study, they found no correlation between volume symmetry and ‘Satisfaction with breasts’ but they did find that patients were able to perceive volume difference on answering the sub-questions.…”

Section: Discussionmentioning

confidence: 97%

The potential role of three-dimensional surface imaging as a tool to evaluate aesthetic outcome after Breast Conserving Therapy (BCT)

O’Connell

Micco

Khabra

et al. 2017

Breast Cancer Res Treat

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PurposeTo establish whether objective measurements of symmetry of volume and shape using three-dimensional surface imaging (3D-SI) can be used as surrogate markers of aesthetic outcome in patients who have undergone breast conserving therapy (BCT).MethodsWomen who had undergone unilateral BCT in the preceding 1–6 years were invited to participate. Participants completed a satisfaction questionnaire (BREAST-Q) and underwent 3D-SI. Volume and surface symmetry were measured on the images. Assessment of aesthetic outcome was undertaken by a panel of clinicians. The Kruskal–Wallis test was used to assess the relationship between volume and shape symmetry measurements with the panel score. Spearman’s rho correlations were used to assess the relationship between the measurements and patient satisfaction.Results200 women participated. Median volume symmetry was 87% (IQR 78–93) and shape symmetry was 5.9 mm (IQR 4.2–8.0). The participants were grouped according to panel assessment of aesthetic outcome (poor, fair, good, excellent) and the median volume and shape symmetry was calculated for each group. Volume symmetry significantly differed between the groups. Post hoc pairwise comparisons demonstrated that these differences existed between panel scores of fair versus good and good versus excellent. Median shape symmetry also differed according to patient panel groups with four significant pairwise comparisons between poor versus good, poor versus excellent, fair versus good and fair versus excellent. There was a significant but weak correlation of both volume symmetry and surface asymmetry with BREAST-Q scores (correlation coefficients 0.187 and −0.229, respectively).ConclusionBreast volume and shape symmetry are both associated with panel assessment scores and patient satisfaction. The objective volume and shape symmetry measures were strongly associated with panel assessment scores, such that a 3D-SI tool could replace panel assessment as a faster and more objective method of evaluating aesthetic outcomes.

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“…Yip et al scanned the breast volume with a 3D laser, but could not find a correlation between postoperative breast volume symmetry and patient satisfaction [9]. Godwin et al noted that even after improvements in surgical techniques in the last years, patient satisfaction after surgery is still higher than surgeon satisfaction [10].…”

Section: Discussionmentioning

confidence: 99%

Objective breast symmetry analysis with the breast analyzing tool (BAT): improved tool for clinical trials

Krois

Romar

Wild

et al. 2017

Breast Cancer Res Treat

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PurposeObjective cosmetic analysis is important to evaluate the cosmetic outcome after breast surgery or breast radiotherapy. For this purpose, we aimed to improve our recently developed objective scoring software, the Breast Analyzing Tool (BAT®).MethodsA questionnaire about important factors for breast symmetry was handed out to ten experts (surgeons) and eight non-experts (students). Using these factors, the first-generation BAT® software formula has been modified and the breast symmetry index (BSI) from 129 women after breast surgery has been calculated by the first author with this new BAT® formula. The resulting BSI values of these 129 breast cancer patients were then correlated with subjective symmetry scores from the 18 observers using the Harris scale. The BSI of ten images was also calculated from five observers different from the first author to calculate inter-rater reliability. In a second phase, the new BAT® formula was validated and correlated with subjective scores of additional 50 women after breast surgery.ResultsThe inter-rater reliability analysis of the objective evaluation by the BAT® from five individuals showed an ICC of 0.992 with almost no difference between different observers. All subjective scores of 50 patients correlated with the modified BSI score with a high Pearson correlation coefficient of 0.909 (p < .001) which was better compared to the old software (r = 0.769; p < .001).ConclusionsThe modified BAT® software improves the correlation between subjective and objective BSI values, and may be a new standard for trials evaluating breast symmetry.

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Determinants of breast reconstruction outcome: How important is volume symmetry?

Cited by 34 publications

References 33 publications

Contralateral breast symmetrisation in unilateral DIEP flap breast reconstruction

Contralateral breast symmetrisation in unilateral DIEP flap breast reconstruction

The potential role of three-dimensional surface imaging as a tool to evaluate aesthetic outcome after Breast Conserving Therapy (BCT)

Objective breast symmetry analysis with the breast analyzing tool (BAT): improved tool for clinical trials

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