Objective measurement of cosmetic outcomes of breast conserving therapy using BCCT.core

Abstract

Purpose The purpose of this study is to evaluate objective cosmetic outcomes and factors related to breast-conserving therapy (BCT) using the BCCT.core software. Materials and Methods Fifty-one patients who received BCT with informed consent were evaluated using the BCCT.core software. Patients were divided into two groups based on the BCCT score: excellent or good (n=42) vs. fair or poor (n=9). Analysis of clinical factors was performed to determine factors affecting cosmetic outcomes. Results The objective cosmetic outcome of BCT measured using the BCCT.core software was excellent in 10% of patients, good in 72%, and fair in 18%. None of the patients were classified as poor outcome. Tumor characteristics, systemic adjuvant therapy (chemotherapy and hormonal therapy), and radiation dose or energy of electron boost did not show correlation with the score measured by the BCCT.core program (p > 0.05). In univariate analysis, maximum dose within the breast (D-max), width of tangential field, and excised tumor volume were smaller in patients with excellent or good by the BCCT.core compared to those with fair or poor (D-max, 110.2 +/- 1.5% vs. 111.6 +/- 1.7%, p=0.019; width of tangential field, 8.0 +/- 1.1 cm vs. 8.6 +/- 0.7 cm, p=0.034; excised tumor volume, 64.0 +/- 35.8 cm(3) vs. 95.3 +/- 54.4 cm(3), p=0.067). In multivariate analysis, only D-max was a significant factor for breast cosmetic outcome with a risk ratio of 1.697 (95% confidence interval, 1.006 to 2.863; p=0.047). Conclusion Objective measurement of cosmetic outcome of BCT using the BCCT.core software was feasible. The cosmetic outcome of BCT may be affected by the maximum dose within the breast.