Breast-specific factors determine cosmetic outcome and patient satisfaction after breast-conserving therapy: Results from the randomized COBALT study

José H. Volders, Vera L. Negenborn, Max H. Haloua, Nicole M. A. Krekel, Katarzyna Jóźwiak, Sybren Meijer, Petrousjka M. van den Tol

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Background and Objectives: To identify breast-specific factors and the role of tumor, treatment, and patient-related items in influencing patient opinion on cosmesis and satisfaction after breast-conserving therapy (BCT). Methods: Data from the randomized COBALT study was used. At 3, 12, and 36 months, 128 patients with T1-T2 breast cancer completed a questionnaire on breast-specific factors and overall cosmetic outcome and patient satisfaction, using a 4-point Likert scale. Results: There was a strong positive correlation between breast-specific factors, overall cosmetic outcome,and satisfaction at all time-points. Excellent/good cosmetic outcomes and satisfaction decreased during follow-up. A shift was noted in the degree of influence of the various breast-specific factors. At 3 years, symmetry factors such as size, shape, and nipple position largely determined a patient's opinion on the final cosmesis, followed by firmness. The risk of an unacceptable outcome was associated with young age and large excision volumes. Conclusion: A questionnaire including breast-specific questions provides important information on final cosmetic results and satisfaction after BCT. These outcomes can also be of great value as quality indicators and pre-operative counseling. The major influence of breast-specific factors on asymmetry underlines the importance of achieving an optimal excision volume at the initial procedure.
Original languageEnglish
Pages (from-to)1001-1008
Number of pages8
JournalJournal of Surgical Oncology
Volume117
Issue number5
DOIs
Publication statusPublished - 2018

Cite this

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title = "Breast-specific factors determine cosmetic outcome and patient satisfaction after breast-conserving therapy: Results from the randomized COBALT study",
abstract = "Background and Objectives: To identify breast-specific factors and the role of tumor, treatment, and patient-related items in influencing patient opinion on cosmesis and satisfaction after breast-conserving therapy (BCT). Methods: Data from the randomized COBALT study was used. At 3, 12, and 36 months, 128 patients with T1-T2 breast cancer completed a questionnaire on breast-specific factors and overall cosmetic outcome and patient satisfaction, using a 4-point Likert scale. Results: There was a strong positive correlation between breast-specific factors, overall cosmetic outcome,and satisfaction at all time-points. Excellent/good cosmetic outcomes and satisfaction decreased during follow-up. A shift was noted in the degree of influence of the various breast-specific factors. At 3 years, symmetry factors such as size, shape, and nipple position largely determined a patient's opinion on the final cosmesis, followed by firmness. The risk of an unacceptable outcome was associated with young age and large excision volumes. Conclusion: A questionnaire including breast-specific questions provides important information on final cosmetic results and satisfaction after BCT. These outcomes can also be of great value as quality indicators and pre-operative counseling. The major influence of breast-specific factors on asymmetry underlines the importance of achieving an optimal excision volume at the initial procedure.",
keywords = "Adult, Aged, Body Image, Breast Neoplasms/surgery, Cosmetic Techniques, Female, Follow-Up Studies, Humans, Mastectomy, Segmental, Middle Aged, Patient Satisfaction, Prognosis, Quality of Life",
author = "Volders, {Jos{\'e} H.} and Negenborn, {Vera L.} and Haloua, {Max H.} and Krekel, {Nicole M. A.} and Katarzyna J{\'o}źwiak and Sybren Meijer and {van den Tol}, {Petrousjka M.}",
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year = "2018",
doi = "10.1002/jso.25012",
language = "English",
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pages = "1001--1008",
journal = "Journal of Surgical Oncology",
issn = "0022-4790",
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Breast-specific factors determine cosmetic outcome and patient satisfaction after breast-conserving therapy : Results from the randomized COBALT study. / Volders, José H.; Negenborn, Vera L.; Haloua, Max H.; Krekel, Nicole M. A.; Jóźwiak, Katarzyna; Meijer, Sybren; van den Tol, Petrousjka M.

In: Journal of Surgical Oncology, Vol. 117, No. 5, 2018, p. 1001-1008.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Breast-specific factors determine cosmetic outcome and patient satisfaction after breast-conserving therapy

T2 - Results from the randomized COBALT study

AU - Volders, José H.

AU - Negenborn, Vera L.

AU - Haloua, Max H.

AU - Krekel, Nicole M. A.

AU - Jóźwiak, Katarzyna

AU - Meijer, Sybren

AU - van den Tol, Petrousjka M.

N1 - © 2018 Wiley Periodicals, Inc.

PY - 2018

Y1 - 2018

N2 - Background and Objectives: To identify breast-specific factors and the role of tumor, treatment, and patient-related items in influencing patient opinion on cosmesis and satisfaction after breast-conserving therapy (BCT). Methods: Data from the randomized COBALT study was used. At 3, 12, and 36 months, 128 patients with T1-T2 breast cancer completed a questionnaire on breast-specific factors and overall cosmetic outcome and patient satisfaction, using a 4-point Likert scale. Results: There was a strong positive correlation between breast-specific factors, overall cosmetic outcome,and satisfaction at all time-points. Excellent/good cosmetic outcomes and satisfaction decreased during follow-up. A shift was noted in the degree of influence of the various breast-specific factors. At 3 years, symmetry factors such as size, shape, and nipple position largely determined a patient's opinion on the final cosmesis, followed by firmness. The risk of an unacceptable outcome was associated with young age and large excision volumes. Conclusion: A questionnaire including breast-specific questions provides important information on final cosmetic results and satisfaction after BCT. These outcomes can also be of great value as quality indicators and pre-operative counseling. The major influence of breast-specific factors on asymmetry underlines the importance of achieving an optimal excision volume at the initial procedure.

AB - Background and Objectives: To identify breast-specific factors and the role of tumor, treatment, and patient-related items in influencing patient opinion on cosmesis and satisfaction after breast-conserving therapy (BCT). Methods: Data from the randomized COBALT study was used. At 3, 12, and 36 months, 128 patients with T1-T2 breast cancer completed a questionnaire on breast-specific factors and overall cosmetic outcome and patient satisfaction, using a 4-point Likert scale. Results: There was a strong positive correlation between breast-specific factors, overall cosmetic outcome,and satisfaction at all time-points. Excellent/good cosmetic outcomes and satisfaction decreased during follow-up. A shift was noted in the degree of influence of the various breast-specific factors. At 3 years, symmetry factors such as size, shape, and nipple position largely determined a patient's opinion on the final cosmesis, followed by firmness. The risk of an unacceptable outcome was associated with young age and large excision volumes. Conclusion: A questionnaire including breast-specific questions provides important information on final cosmetic results and satisfaction after BCT. These outcomes can also be of great value as quality indicators and pre-operative counseling. The major influence of breast-specific factors on asymmetry underlines the importance of achieving an optimal excision volume at the initial procedure.

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KW - Aged

KW - Body Image

KW - Breast Neoplasms/surgery

KW - Cosmetic Techniques

KW - Female

KW - Follow-Up Studies

KW - Humans

KW - Mastectomy, Segmental

KW - Middle Aged

KW - Patient Satisfaction

KW - Prognosis

KW - Quality of Life

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UR - https://www.ncbi.nlm.nih.gov/pubmed/29473960

U2 - 10.1002/jso.25012

DO - 10.1002/jso.25012

M3 - Article

VL - 117

SP - 1001

EP - 1008

JO - Journal of Surgical Oncology

JF - Journal of Surgical Oncology

SN - 0022-4790

IS - 5

ER -