Abstract

AIM: To compare two different evaluation of cosmetic outcome in patients undergoing breast conserving surgery (BCS) and breast reduction for breast cancer and to evaluate the factors affecting cosmetic outcome. MATERIAL and METHOD: In our clinic between 1999-2008, 28 breast cancer patients accepted to participate our study,who were treated by breast reduction and BCS were investigated. Cosmetic results of 28 patients were evaluated by physical examination and 6 photos taken by a digital camera and examined by 6 assessors using 13 parameters. The assessments of the cosmetic outcome were done by result (very good, good, moderate, bad) and point system (very good-0, well - 1, medium-2, bad-3).Two rounds of evaluation panel including 5 surgeons was arranged.The results of physical examination and photographic evaluation, result and point system, personal and panel results were statistically compared. The factors changing the cosmetic outcome were investigated. FINDINGS: When physical exam and photographic exam of 28 cases were compared, photographic exam was found superior to physical exam both in point and result system and this superiority was statistically meaningful with p=0.000 value. When physical examination point and physical examination result were compared to photographic examination point and photographic examination results, although the results yield better than the points, the difference was not significant statistically (p=0.997 ve p=0.658). When personal photographic evaluations were compared with the panel results, it was seen that personal evaluation was significantly worse than the panel results as point and result. As the good result of the patient evaluation was 64.3%, this value was 35.7% for the panel with a significant difference (p=0.004). The factors impacting the cosmesis positively were BCS compared to reduction (p=0.026), body mass index (BMI) < 31 (p=0.03), and the specimen weight less than 250 grams (p=0.041) was meaningful. The low number of the series unabled us to evaluate any significancy on the factors such as the different technique of flaps, radiotherapy center, duration of follow-up and cancer stage. CONCLUSION: This study shows that in the evaluation of the cosmetic results of applied conservative techniques (including BCS and breast reduction), panel (at least 3 persons physician group) and photographic techniques were superior to personal and physical examination methods.Evaluation by point was not superior to result evaluation statistically. The patients’ self assesments of cosmesis were signicantly superior to surgeons. BMI<31, specimen weight under 250 gr. And BCS versus reduction were positively impacting the cosmetic outcome.