Limited usefulness of observer-based cosmesis scales employed to evaluate patients treated conservatively for breast cancer

Factors affecting cosmetic outcome in breast-conserving cancer treatment — objective quantitative assessment

“…In these studies cosmetic outcome was based upon evaluation by the treating physician. Due to subjective observer bias, analyses such as these may be of limited usefulness in critically evaluating factors related to cosmetic outcome [17]. Moreover, most studies combined all types of cosmetic changes into one overall assessment.…”

Comparing two objective methods for the aesthetic evaluation of breast cancer conservative treatment

“…Subjective methods have been largely used, either through direct patient evaluation or through a photograph, performed by one or several observers [3]. However, results of subjective evaluation show only a modest interobserver agreement, even when performed by experts [7,8]. Objective methods use measurements taken directly from the patient or from photographs, and are based essentially on asymmetries between treated and non-treated breasts [9,10].…”

Breast reconstruction following prophylactic or therapeutic mastectomy for breast cancer: Recommendations from an evidence-based provincial guideline

“…No randomized controlled trials have been performed to compare these two main methods of reconstruction in terms of cosmesis, complications and oncological safety in patients with breast cancer. Furthermore, the few observational studies available in the literature have used varying, nonstandardized measures to assess aesthetic outcomes (41,42). Factors such as cost (43), pain (44), aesthetics (45)(46)(47), feasibility with radiotherapy (48,49) and complication rates (50-53) have been used to rank one reconstructive procedure over another.…”