Breast compliance: a new method for evaluation of cosmetic outcome after conservative treatment of early breast cancer.

As a measure of cosmetic outcome, the compliance of normal and irradiated breasts has been quantified using a new method of Breast Compliance Evaluation (BCE). A total of 151 women were studied, of whom 100 were normal controls and 51 had previous breast irradiation as part of breast-conserving treatment. Compliance was taken as the difference between the anterior breast surface length from infra-mammary fold to the nipple when the patient was in erect and supine positions. Irradiated cases were rated as having satisfactory outcome (good or excellent cosmetic result) or unsatisfactory (fair or poor cosmetic result). Mean compliance of normal cases was 1.8 cm. In the irradiated women with satisfactory cosmetic results, mean compliance was 1.45 compared with only 0.77 cm in those with unsatisfactory outcome. The difference between the compliance of both breasts was 0.1 cm for the controls, 0.3 cm in the satisfactory group and 2 cm in the unsatisfactory group. A difference in compliance greater than 1 cm was usually associated with an unsatisfactory cosmetic outcome. Factors determining cosmetic outcome included volume of excised lump and breast size. The cosmetic result was not affected by tumour site, clinical or pathological tumour size, or the total number of axillary nodes excised. This simple, painless, and easily reproducible measurement may be a useful objective indicator of cosmetic result after conservative treatment of early breast cancer.