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Three-dimensional simulation of aesthetic outcome from breast-conserving surgery compared with viewing photographs or standard care: randomized clinical trial.

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Godden Rusby Simulation breast conservation BJS 2021.pdf (668.5Kb)
Date
2021-10-23
ICR Author
Khan, Aadil
Kirby, Anna
Rusby, Jennifer
Author
Godden, AR
Micha, A
Wolf, LM
Pitches, C
Barry, PA
Khan, AA
Krupa, KDC
Kirby, AM
Rusby, JE
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Type
Journal Article
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Abstract
INTRODUCTION: Over half of women with surgically managed breast cancer in the UK undergo breast-conserving treatment (BCT). While photographs are shown prior to reconstructive surgery or complex oncoplastic procedures, standard practice prior to breast conservation is to simply describe the likely aesthetic changes. Patients have expressed the desire for more personalized information about likely appearance after surgery. The hypothesis was that viewing a three-dimensional (3D) simulation improves patients' confidence in knowing their likely aesthetic outcome after surgery. METHODS: A randomized, controlled trial of 117 women planning unilateral BCT was undertaken. The randomization was three-way: standard of care (verbal description alone, control group), viewing two-dimensional (2D) photographs, or viewing a 3D simulation before surgery. The primary endpoint was the comparison between groups' median answer on a visual analogue scale (VAS) for the question administered before surgery: 'How confident are you that you know how your breasts are likely to look after treatment?' RESULTS: The median VAS in the control group was 5.2 (i.q.r. 2.6-7.8); 8.0 (i.q.r. 5.7-8.7) for 2D photography, and 8.9 (i.q.r. 8.2-9.5) for 3D simulation. There was a significant difference between groups (P < 0.010) with post-hoc pairwise comparisons demonstrating a statistically significant difference between 3D simulation and both standard care and viewing 2D photographs (P < 0.010 and P = 0.012, respectively). CONCLUSION: This RCT has demonstrated that women who viewed an individualized 3D simulation of likely aesthetic outcome for BCT were more confident going into surgery than those who received standard care or who were shown 2D photographs of other women. The impact on longer-term satisfaction with outcome remains to be determined.Registration number: NCT03250260 (http://www.clinicaltrials.gov).
URI
https://repository.icr.ac.uk/handle/internal/5255
DOI
https://doi.org/10.1093/bjs/znab217
https://doi.org/10.1093/bjs/znab217
 
Collections
  • Radiotherapy and Imaging
Subject
Aged
Breast Neoplasms
Computer Simulation
Esthetics
Female
Humans
Imaging, Three-Dimensional
Mammaplasty
Mastectomy, Segmental
Middle Aged
Patient Education as Topic
Photography
Research team
Trans Locoregional Therap
Language
eng
Date accepted
2021-05-06
License start date
2021-10-23
Citation
British Journal of Surgery, 2021, 108 (10), pp. 1181 - 1188
Publisher
OXFORD UNIV PRESS

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