Patterson M P, Pezner R D, Hill L R, Vora N L, Desai K R, Lipsett J A
Int J Radiat Oncol Biol Phys. 1985 Oct;11(10):1849-52. doi: 10.1016/0360-3016(85)90044-6.
Thirty-two patients with Stage I or II breast cancer who had completed conservative breast-preserving treatment were asked to rate their cosmetic outcomes. Within this group, extent of the surgical excision of the breast tumor varied, with biopsy scars ranging from 2 to 19.5 cm. All patients had received external beam radiotherapy, with local boost doses in 17 cases. The average interval between self-evaluation and the completion of radiotherapy was 19 months. Patients completed a questionnaire rating the appearance of the treated breast, the degree of difference between breasts and overall satisfaction with cosmesis. They were asked to describe differences between breasts and to make any additional comments. Appearance of the treated breast was rated good to excellent by 94%, although 88% noted a difference of slight to moderate degree between treated and untreated breasts. Overall, 78% of patients were very to extremely satisfied, while moderate satisfaction was reported by 19%. Reports of breast differences included reduced size of the treated breast (44%), increased firmness (31%), elevation (25%), and skin color changes (22%). Reasons for dissatisfaction included chronic breast pain in 3 patients, breast edema in one and arm edema in one. Two patients wanted the untreated breast reduced in size. Statistically significant inverse relationships were found between the length of the biopsy scar and patient ratings of both appearance of the treated breast and overall satisfaction. These results indicated that although most patients were satisfied with cosmetic results of breast-preserving treatments, they are quite discriminating in their evaluations of differences between breasts. Functional factors such as pain and edema had a negative impact on satisfaction with cosmesis.
32例完成保乳保守治疗的Ⅰ期或Ⅱ期乳腺癌患者被要求对其美容效果进行评分。在该组患者中，乳腺肿瘤手术切除范围各异，活检瘢痕长度从2厘米至19.5厘米不等。所有患者均接受了外照射放疗，其中17例接受了局部加量照射。自我评估与放疗结束之间的平均间隔为19个月。患者完成了一份问卷，对治疗侧乳房的外观、双侧乳房的差异程度以及对美容效果的总体满意度进行评分。他们被要求描述双侧乳房的差异并发表任何其他意见。94%的患者对治疗侧乳房的外观评价为良好至优秀，尽管88%的患者指出治疗侧与未治疗侧乳房存在轻微至中度的差异。总体而言，78%的患者非常满意至极满意，19%的患者表示中度满意。关于乳房差异的报告包括治疗侧乳房尺寸减小（44%）、硬度增加（31%）、抬高（25%）和皮肤颜色改变（22%）。不满意的原因包括3例患者出现慢性乳房疼痛、1例出现乳房水肿和1例出现手臂水肿。2例患者希望减小未治疗侧乳房的尺寸。活检瘢痕长度与患者对治疗侧乳房外观和总体满意度的评分之间存在统计学上显著的负相关关系。这些结果表明，尽管大多数患者对保乳治疗的美容效果感到满意，但他们在评估双侧乳房差异时非常挑剔。疼痛和水肿等功能因素对美容满意度有负面影响。
