Methods for the Aesthetic Evaluation of Breast Cancer Conservation Treatment: A Technological Review

Abstract

Breast-conserving approaches aim to attain better aesthetic results in addition to local control and achieving survival rates equivalent to mastectomy in patients with breast cancer. While the oncologic outcome of breast conservation procedures is easily estimated objectively by disease-free and overall survival rates, the cosmetic outcome has no standard of evaluation. Although breast conservation techniques have been widely studied, different forms of evaluation and heterogeneous working practices have contributed to different aesthetic results. As this scenario suggests, the evaluation of aesthetic results should be mandatory in any institution performing breast cancer treatment, contributing to the improvement of current strategies by enabling the identification of variables which have a significant impact on the final aesthetic result. In the process of assessing cosmetic outcomes there are several important issues that should be considered: which factors have a crucial impact on the cosmetic outcome of Breast Cancer Conservation Treatment (BCCT); which parameters or features should be evaluated in the cosmetic assessment of BCCT; how patients are evaluated; which scales are used in this evaluation; which methods and technological solutions are available for the evaluation of cosmetic results of BCCT. In this paper we try to discuss all these questions, with an emphasis on the objective methods and corresponding technologies used in the aesthetic evaluation of BCCT. The most relevant publications related to the mentioned topics are presented, critically analysed and put in chronological perspective. Current and future trends are also discussed.