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Cosmetic evaluation methods adapted to asian patients after breast-conserving surgery and examination of the necessarily elements for cosmetic evaluation.

Nohara Y, Hanamura N, Zaha H, Kimura H, Kashikura Y, Nakamura T, Noro A, Imai N, Shibusawa M, Ogawa T - J Breast Cancer (2015)

Bottom Line: In order to examine the necessary elements for developing a new ideal method, 100 out of 190 were selected and assessed separately by six raters using both the Harris and modified Sawai group methods in the observer assessment.The results of the BCCT.core and the other two methods were clearly different.In the observer assessment, the consensuses of the six raters were evaluated as follows: 27, 27, 26, and 20 cases were evaluated as "excellent," "good," "fair," and "poor," respectively.

View Article: PubMed Central - PubMed

Affiliation: Department of Breast Surgery, Mie University Hospital, Mie, Japan.

ABSTRACT

Purpose: Although various strategies have been reported, there are no defined criteria for cosmetic evaluation methods after breast-conserving surgery (BCS). Since Asians tend to have smaller breasts, indistinct inframammary folds, and conspicuous scars, differences in the cosmetic results are expected. So we examined two subjective methods and one objective method to determine the differences, and elements necessary for a cosmetic evaluation after BCS.

Methods: Frontal photographs of 190 Japanese were evaluated using the Harris scale (Harris) and the evaluation method proposed by the Japanese Breast Cancer Society Sawai group (Sawai group) as the subjective methods, and the Breast Cancer Conservation Treatment cosmetic results (BCCT.core) as the objective method, respectively. In order to examine the necessary elements for developing a new ideal method, 100 out of 190 were selected and assessed separately by six raters using both the Harris and modified Sawai group methods in the observer assessment. The correlation between the two methods was examined using the Spearman rank-correlation coefficient.

Results: The results of the BCCT.core and the other two methods were clearly different. In the observer assessment, the consensuses of the six raters were evaluated as follows: 27, 27, 26, and 20 cases were evaluated as "excellent," "good," "fair," and "poor," respectively. For the Spearman rank-correlation coefficient, values higher than 0.7 indicated a strong correlation, as seen by the values of 0.909 for the breast shape and 0.345 for the scar. The breast shape accounted for the most significant part of the evaluation, and the scar had very little correlation.

Conclusion: In this study, we recognized a clear difference between the subjective and objective evaluation methods, and identified the necessary elements for cosmetic evaluation. We would like to continue developing an ideal cosmetic evaluation that is similar to subjective one and is independent from raters.

No MeSH data available.


Related in: MedlinePlus

Relationship between scores rated by items of modified Sawai group and evaluation results obtained from the consensus. (A) Relationship between breast size and consensus. (B) Relationship between breast shape and consensus. (C) Relationship between scar and consensus. (D) Relationship between nipple and areola size/shape and consensus. (E) Relationship between nipple and areola color tone and consensus. (F) Relationship between nipple position and consensus. (G) Relationship between position of the maximum descent point and consensus.
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Figure 2: Relationship between scores rated by items of modified Sawai group and evaluation results obtained from the consensus. (A) Relationship between breast size and consensus. (B) Relationship between breast shape and consensus. (C) Relationship between scar and consensus. (D) Relationship between nipple and areola size/shape and consensus. (E) Relationship between nipple and areola color tone and consensus. (F) Relationship between nipple position and consensus. (G) Relationship between position of the maximum descent point and consensus.

Mentions: Scores rated by the six raters were calculated (30 scores in total) by items of the modified Sawai group, and the relationship between these scores and evaluation results obtained from the whole consensus (excellent/good/fair/poor) was shown in graphs (Figure 2). In addition, the correlation coefficient is shown as Spearman rank-correlation coefficient (Table 2). The shape of breasts showed the strongest correlation coefficient at 0.909 (Figure 2B), as indicated by the upwardsloping straight line in the figure. This was followed by the breast size 0.791 (Figure 2A) and the position of the maximum descent points 0.758 (Figure 2G). These items also showed upward-sloping lines in graphs of whole consensus (from "poor" to "excellent"), showing positive correlation. On the other hand, the scar showed the weakest correlation coefficient at 0.345 (Figure 2C), which means that it had almost no influence on the whole consensus. The line in the graph was also flat and showed that the scar had minimal influence on the evaluation results. Moderate correlation coefficient was observed in this order: nipple position, 0.690 (Figure 2F); nipple and areola size/shape, 0.647 (Figure 2D); and nipple and areola color tone, 0.542 (Figure 2E). The cosmetic evaluation is composed in order of breast shape>breast size>position of the maximum descent>nipple position>nipple and areola size/shape>nipple and areola color tone>scar.


Cosmetic evaluation methods adapted to asian patients after breast-conserving surgery and examination of the necessarily elements for cosmetic evaluation.

Nohara Y, Hanamura N, Zaha H, Kimura H, Kashikura Y, Nakamura T, Noro A, Imai N, Shibusawa M, Ogawa T - J Breast Cancer (2015)

Relationship between scores rated by items of modified Sawai group and evaluation results obtained from the consensus. (A) Relationship between breast size and consensus. (B) Relationship between breast shape and consensus. (C) Relationship between scar and consensus. (D) Relationship between nipple and areola size/shape and consensus. (E) Relationship between nipple and areola color tone and consensus. (F) Relationship between nipple position and consensus. (G) Relationship between position of the maximum descent point and consensus.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4381128&req=5

Figure 2: Relationship between scores rated by items of modified Sawai group and evaluation results obtained from the consensus. (A) Relationship between breast size and consensus. (B) Relationship between breast shape and consensus. (C) Relationship between scar and consensus. (D) Relationship between nipple and areola size/shape and consensus. (E) Relationship between nipple and areola color tone and consensus. (F) Relationship between nipple position and consensus. (G) Relationship between position of the maximum descent point and consensus.
Mentions: Scores rated by the six raters were calculated (30 scores in total) by items of the modified Sawai group, and the relationship between these scores and evaluation results obtained from the whole consensus (excellent/good/fair/poor) was shown in graphs (Figure 2). In addition, the correlation coefficient is shown as Spearman rank-correlation coefficient (Table 2). The shape of breasts showed the strongest correlation coefficient at 0.909 (Figure 2B), as indicated by the upwardsloping straight line in the figure. This was followed by the breast size 0.791 (Figure 2A) and the position of the maximum descent points 0.758 (Figure 2G). These items also showed upward-sloping lines in graphs of whole consensus (from "poor" to "excellent"), showing positive correlation. On the other hand, the scar showed the weakest correlation coefficient at 0.345 (Figure 2C), which means that it had almost no influence on the whole consensus. The line in the graph was also flat and showed that the scar had minimal influence on the evaluation results. Moderate correlation coefficient was observed in this order: nipple position, 0.690 (Figure 2F); nipple and areola size/shape, 0.647 (Figure 2D); and nipple and areola color tone, 0.542 (Figure 2E). The cosmetic evaluation is composed in order of breast shape>breast size>position of the maximum descent>nipple position>nipple and areola size/shape>nipple and areola color tone>scar.

Bottom Line: In order to examine the necessary elements for developing a new ideal method, 100 out of 190 were selected and assessed separately by six raters using both the Harris and modified Sawai group methods in the observer assessment.The results of the BCCT.core and the other two methods were clearly different.In the observer assessment, the consensuses of the six raters were evaluated as follows: 27, 27, 26, and 20 cases were evaluated as "excellent," "good," "fair," and "poor," respectively.

View Article: PubMed Central - PubMed

Affiliation: Department of Breast Surgery, Mie University Hospital, Mie, Japan.

ABSTRACT

Purpose: Although various strategies have been reported, there are no defined criteria for cosmetic evaluation methods after breast-conserving surgery (BCS). Since Asians tend to have smaller breasts, indistinct inframammary folds, and conspicuous scars, differences in the cosmetic results are expected. So we examined two subjective methods and one objective method to determine the differences, and elements necessary for a cosmetic evaluation after BCS.

Methods: Frontal photographs of 190 Japanese were evaluated using the Harris scale (Harris) and the evaluation method proposed by the Japanese Breast Cancer Society Sawai group (Sawai group) as the subjective methods, and the Breast Cancer Conservation Treatment cosmetic results (BCCT.core) as the objective method, respectively. In order to examine the necessary elements for developing a new ideal method, 100 out of 190 were selected and assessed separately by six raters using both the Harris and modified Sawai group methods in the observer assessment. The correlation between the two methods was examined using the Spearman rank-correlation coefficient.

Results: The results of the BCCT.core and the other two methods were clearly different. In the observer assessment, the consensuses of the six raters were evaluated as follows: 27, 27, 26, and 20 cases were evaluated as "excellent," "good," "fair," and "poor," respectively. For the Spearman rank-correlation coefficient, values higher than 0.7 indicated a strong correlation, as seen by the values of 0.909 for the breast shape and 0.345 for the scar. The breast shape accounted for the most significant part of the evaluation, and the scar had very little correlation.

Conclusion: In this study, we recognized a clear difference between the subjective and objective evaluation methods, and identified the necessary elements for cosmetic evaluation. We would like to continue developing an ideal cosmetic evaluation that is similar to subjective one and is independent from raters.

No MeSH data available.


Related in: MedlinePlus