3-Dimensional objective aesthetic evaluation to replace panel assessment after breast-conserving treatment

Area of Science:

• Medical Imaging
• Oncology
• Plastic Surgery

Background:

• Breast-conserving treatment (BCT) is common for early breast cancer, with aesthetic outcomes significantly impacting patient wellbeing.
• Current aesthetic assessment relies on panel scoring, which has limitations and lacks a gold standard for measuring symmetry.
• Objective measurement using 3-dimensional surface images (3D-SI) offers a potential solution for evaluating BCT aesthetic outcomes.

Purpose of the Study:

• To develop and validate an objective model for assessing aesthetic outcomes after BCT using 3D-SI.
• To identify key 3D measurements that predict subjective panel scores.
• To establish a reliable and unbiased method for evaluating aesthetic results in breast cancer patients.

Main Methods:

• Collected 3D-SI data from women who underwent BCT 1-5 years prior.
• Used univariate analysis to correlate objective 3D measurements with panel scores.
• Developed a forward stepwise multiple linear regression model to predict panel scores using 3D measurements and validated it on an independent set.

Main Results:

• High intra-panel reliability was achieved in both training and validation sets (wκ = 0.87, 0.84).
• A six-variable multivariate model demonstrated good correlation between predicted and observed panel scores (r = 0.68, 0.65).
• Model calibration improved the distribution of predicted scores, showing good predictive accuracy.

Conclusions:

• A validated six-variable objective model for BCT aesthetic outcome assessment has been developed using 3D-SI.
• This model can objectively predict aesthetic outcomes, offering a potential replacement for subjective panel assessments.
• The model facilitates unbiased evaluation, comparison, and benchmarking of aesthetic results in breast cancer treatment.