St George Cancer Care Centre, St George Hospital, Kogarah, New South Wales, Australia.
Centre for Research in Nursing and Health, St George Hospital, Kogarah, New South Wales, Australia.
J Med Imaging Radiat Oncol. 2021 Oct;65(6):817-825. doi: 10.1111/1754-9485.13190. Epub 2021 May 10.
Breast cancer conservative treatment software (BCCT.core) has the potential to provide objective results using digital photographs, thus increasing the reliability, limiting the subjective interpretation and standardising the evaluation of breast cosmesis in patients. The aim of this systematic review was to summarise the empirical evidence regarding the agreement between the BCCT.core and other methods used by health professionals and patients to assess breast cosmesis. The Ovid MEDLINE, Embase, CINAHL, PsycINFO and Scopus databases were systematically searched for studies comparing the agreement between BCCT.core and other methods used to assess breast cosmesis. A total of 14 studies involving 2703 patients were included in the review. In studies where patients undertook self-assessment, the percentage agreement ranged from 69.2% to 74.8% and the kappa values ranged from slight (k = 0.12) to fair agreement. There was a low correlation between the BCCT.core and the Harvard scale when patients assessed cosmetic outcomes using photographs of their breasts (r = 0.165). A 75% and 42.8% agreement was reported in studies where clinicians assessed breast cosmesis by directly visualising the patients' breasts and photographs, respectively. Assessment of breast cosmesis by the expert panel using patient photographs reported a percentage agreement ranging from 25% to 83%. The results of this systematic review demonstrated an overall agreement of fair to moderate between the BCCT.core and the subjective scales used to assess breast cosmesis. However, clinician experience and patient values should be considered in clinical decision-making.
乳腺癌保乳治疗软件（BCCT.core）具有使用数字照片提供客观结果的潜力，从而提高了可靠性，限制了主观解释，并使患者乳房美容评估标准化。本系统评价的目的是总结有关 BCCT.core 与健康专业人员和患者用于评估乳房美容的其他方法之间一致性的经验证据。系统地检索了 Ovid MEDLINE、Embase、CINAHL、PsycINFO 和 Scopus 数据库，以查找比较 BCCT.core 与用于评估乳房美容的其他方法之间一致性的研究。共有 14 项涉及 2703 名患者的研究纳入了本综述。在患者进行自我评估的研究中，一致性百分比范围为 69.2%至 74.8%，kappa 值范围为轻度（k=0.12）至中度一致。当患者使用乳房照片评估美容结果时，BCCT.core 与哈佛量表之间相关性较低（r=0.165）。当临床医生通过直接观察患者的乳房和照片评估乳房美容时，分别报告了 75%和 42.8%的一致性。使用患者照片由专家小组评估乳房美容，报告的一致性百分比范围为 25%至 83%。本系统评价的结果表明，BCCT.core 与用于评估乳房美容的主观量表之间总体一致性为中度至轻度。然而，在临床决策中应考虑临床医生的经验和患者的价值观。
