The Aesthetic Items Scale: A Tool for the Evaluation of Aesthetic Outcome after Breast Reconstruction

Rieky E G Dikmans, Lauren E H Nene, Mark-Bram Bouman, Henrica C W de Vet, Marc A M Mureau, Marlon E Buncamper, Hay A H Winters, Marco J P F Ritt, Margriet G Mullender, Rieky E G Dikmans, Lauren E H Nene, Mark-Bram Bouman, Henrica C W de Vet, Marc A M Mureau, Marlon E Buncamper, Hay A H Winters, Marco J P F Ritt, Margriet G Mullender

Abstract

Background: Valid tools to assess aesthetic outcomes after breast reconstructive surgery are scarce. Previously a professional aesthetic assessment scale was introduced, the Aesthetic Items Scale (AIS). We aim to determine if this method is a valid and reliable tool to assess aesthetic outcome after breast reconstructive surgery.

Methods: The study population was consenting women who underwent prophylactic mastectomy with subsequent implant-based breast reconstruction. The aesthetic outcome with regard to breast volume, shape, symmetry, scars, and nipple areola complex was rated on a 5-point scale using standardized photographs to give a summed total score. Photographs were evaluated by the patient, 5 plastic surgeons, and 3 mammography nurses. An overall rating of aesthetic outcome on a 1-10 scale was given separately. We determined the intraclass correlation coefficient and assessed interobserver agreement. To assess validity, we calculated the correlation between total score and overall rating of aesthetic outcome.

Results: Interobserver reliability was highest between plastic surgeons for the subitem and overall scores and ranged between 0.56 and 0.82. The summed score of the AIS correlates strongly with the overall rating in professionals but not in patients.

Conclusions: The AIS is a valid and reliable method for evaluating aesthetic outcome of breast reconstruction by plastic surgeons. The results indicate that patients judge aesthetic outcome differently, taking into account factors that are not represented in the AIS. Professionals can use this method to evaluate surgical results, but other measurements are needed to map satisfaction of the patient with her breasts.

Figures

Fig. 1.
Fig. 1.
Average scoring per item of AIS.

References

    1. Brandberg Y, Arver B, Johansson H, et al. Less correspondence between expectations before and cosmetic results after risk-reducing mastectomy in women who are mutation carriers: a prospective study. Eur J Surg Oncol. 2012;38:38–43..
    1. Gilmour A, Mackay IR, Young D, et al. The use of real-time digital video in the assessment of post-operative outcomes of breast reconstruction. J Plast Reconstr Aesthet Surg. 2014;67:1357–1363..
    1. Asplund O, Nilsson B. Interobserver variation and cosmetic result of submuscular breast reconstruction. Scand J Plast Reconstr Surg. 1984;18:215–220..
    1. Brandberg Y, Malm M, Blomqvist L. A prospective and randomized study, “SVEA,” comparing effects of three methods for delayed breast reconstruction on quality of life, patient-defined problem areas of life, and cosmetic result. Plast Reconstr Surg. 2000;105:66–74.; discussion 75.
    1. Cardoso MJ, Cardoso J, Santos AC, et al. Interobserver agreement and consensus over the esthetic evaluation of conservative treatment for breast cancer. Breast. 2006;15:52–57..
    1. Charfare H, MacLatchie E, Cordier C. A comparison of different methods of assessing aesthetic outcome following breast-conserving surgery and factors influencing aesthetic outcome. Br J Med Pract 2010;3(1):310–5..
    1. Edsander-Nord A, Brandberg Y, Wickman M. Quality of life, patients’ satisfaction, and aesthetic outcome after pedicled or free TRAM flap breast surgery. Plast Reconstr Surg. 2001;107:1142–53.; discussion 1154.
    1. Gui GP, Tan SM, Faliakou EC, et al. Immediate breast reconstruction using biodimensional anatomical permanent expander implants: a prospective analysis of outcome and patient satisfaction. Plast Reconstr Surg. 2003;111:125–38.; discussion 139.
    1. Harris JR, Levene MB, Svensson G, et al. Analysis of cosmetic results following primary radiation therapy for stages I and II carcinoma of the breast. Int J Radiat Oncol Biol Phys. 1979;5:257–261..
    1. Mosahebi A, Ramakrishnan V, Gittos M, et al. Aesthetic outcome of different techniques of reconstruction following nipple-areola-preserving envelope mastectomy with immediate reconstruction. Plast Reconstr Surg. 2007;119:796–803..
    1. Sacchini V, Luini A, Tana S, et al. Quantitative and qualitative cosmetic evaluation after conservative treatment for breast cancer. Eur J Cancer. 1991;27:1395–1400..
    1. Gahm J, Jurell G, Edsander-Nord A, et al. Patient satisfaction with aesthetic outcome after bilateral prophylactic mastectomy and immediate reconstruction with implants. J Plast Reconstr Aesthet Surg. 2010;63:332–338..
    1. Visser NJ, Damen TH, Timman R, et al. Surgical results, aesthetic outcome, and patient satisfaction after microsurgical autologous breast reconstruction following failed implant reconstruction. Plast Reconstr Surg. 2010;126:26–36..
    1. Potter S, Harcourt D, Cawthorn S, et al. Assessment of cosmesis after breast reconstruction surgery: a systematic review. Ann Surg Oncol. 2011;18:813–823..
    1. Cardoso MJ, Cardoso J, Amaral N, et al. Turning subjective into objective: the BCCT.core software for evaluation of cosmetic results in breast cancer conservative treatment. Breast. 2007;16:456–461..

Source: PubMed

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