Breast Neoplasms Clinical Trial
Official title:
Comparison of Static Photography and Real Time Digital Video in the Assessment of Aesthetic Outcomes Following Breast Reconstruction
Current qualitative methods of assessing the aesthetic result following breast
reconstruction are known to be poor.
The investigators believe that real time digital video footage followed by expert panel
review would be a superior method of qualitative assessment of breast cancer reconstruction
aesthetics. This has never been studied before.
Breast cancer is the commonest cancer to affect women in the UK. Current guidelines state
that; disease permitting, all females due to undergo mastectomy for breast cancer should be
offered reconstruction. This usually takes place in the form of implant based
reconstruction, regional flap based reconstruction +/- implant or free autologous tissue
based reconstruction.
Traditional methods of subjectively assessing the aesthetic outcome of any of the forms of
breast surgery have been shown to be poor and the assessment of immediate reconstructions a
cumbersome task. The qualitative part of the assessment usually relies on standardised
clinical photographs and panel ratings. Four to six photographs are usually taken of the
patient and their reconstruction from different angles. These photographs are then shown to
an expert panel (usually consisting of healthcare professionals familiar with breast
reconstruction).
A large degree of both inter and intra-observer bias exists when comparing standardized
photographs. The results from expert assessment of cosmesis often do not correlate to the
patients opinion with regards to the cosmetic outcome of their reconstruction
Due to the static nature of clinical photography it does not capture the effect which
movement and gravity play on a reconstructed breast in comparison to a normal breast.
A large volume of information can be captured from a short digital video clip in comparison
to a single photograph. The potential advantages of digital video assessment over
photography are only beginning to be explored with regards to aesthetics in other fields
associated to medicine.9 However this has never been trialed with regards to breast cancer
reconstruction.
We believe that real time digital video footage would be a more valuable tool in the
assessment of breast reconstruction. We believe that there may be more accurate correlations
between patient's satisfaction and panel opinion and that there will be less inter and
intra-observer discordance
;
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