caa a22 4500 445335211 CHVBK 20180317142752.0 cr unu---uuuuu 170323e20110301xx s 000 0 eng 10.1245/s10434-010-1368-6 doi (NATIONALLICENCE)springer-10.1245/s10434-010-1368-6 Assessment of Cosmesis After Breast Reconstruction Surgery: a Systematic Review [Elektronische Daten] [Shelley Potter, Diana Harcourt, Simon Cawthorn, Robert Warr, Nicola Mills, Daphne Havercroft, Jane Blazeby] Background: Breast reconstruction (BR) is undertaken to improve cosmetic outcomes, but how this is optimally assessed is uncertain. This review summarises current methods for assessing cosmesis after reconstructive surgery and makes recommendations for future practice. Methods: A comprehensive systematic review identified all studies with 20 or more participants that evaluated the cosmetic outcome of BR. Four evaluation criteria (reporting of study inclusion criteria, type and timing of BR and timing of assessment) were used to assess study quality. Articles reporting at least three of the four criteria were considered robust and further summarised to report methods of cosmetic assessment, assessor details and the scoring systems used. Results: 122 primary papers assessed cosmesis in 11,308 women with median follow-up of 28.8 months (range 18.0-42.9 months). Cosmesis was assessed by either healthcare professionals or patients in 33 (27.1%) and 37 studies (30.3%), respectively, and by both professionals and patients in 52 (42.6%). Professional assessments included 43 (40.2%) clinical, 49 (45.8%) photographic and 13 (12.1%) geometric assessments conducted by between 1 and 26 observers. Surgeons were most frequently involved in assessments (n=71, 67.6%), but in 38 (36.1%) papers the assessor's profession was not reported. Twenty-seven (25.7%) papers used previously published assessment scale. Patients' views were assessed in 89 studies, using questionnaires (n=63) or interviews (n=12); 14 (15.7%) did not report how patients' views were obtained. Conclusions: Current methods for assessing the cosmetic outcome of BR vary widely. A valid patient-centred assessment method is required to fully understand the outcomes of BR and to inform decision-making. Society of Surgical Oncology, 2010 Potter Shelley Academic Surgical Research Unit, School of Social and Community Medicine, University of Bristol, Bristol, UK aut Harcourt Diana Centre for Appearance Research, University of the West of England, Bristol, UK aut Cawthorn Simon Breast Care Unit, Frenchay Hospital, Bristol, UK aut Warr Robert Department of Plastic Surgery, Frenchay Hospital, Bristol, UK aut Mills Nicola Academic Surgical Research Unit, School of Social and Community Medicine, University of Bristol, Bristol, UK aut Havercroft Daphne Patient Representative, Frenchay Hospital, Bristol, UK aut Blazeby Jane Academic Surgical Research Unit, School of Social and Community Medicine, University of Bristol, Bristol, UK aut Annals of Surgical Oncology Springer-Verlag 18/3(2011-03-01), 813-823 1068-9265 18:3<813 2011 18 10434 https://doi.org/10.1245/s10434-010-1368-6 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1245/s10434-010-1368-6 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Potter Shelley Academic Surgical Research Unit, School of Social and Community Medicine, University of Bristol, Bristol, UK aut NATIONALLICENCE 700 1- Harcourt Diana Centre for Appearance Research, University of the West of England, Bristol, UK aut NATIONALLICENCE 700 1- Cawthorn Simon Breast Care Unit, Frenchay Hospital, Bristol, UK aut NATIONALLICENCE 700 1- Warr Robert Department of Plastic Surgery, Frenchay Hospital, Bristol, UK aut NATIONALLICENCE 700 1- Mills Nicola Academic Surgical Research Unit, School of Social and Community Medicine, University of Bristol, Bristol, UK aut NATIONALLICENCE 700 1- Havercroft Daphne Patient Representative, Frenchay Hospital, Bristol, UK aut NATIONALLICENCE 700 1- Blazeby Jane Academic Surgical Research Unit, School of Social and Community Medicine, University of Bristol, Bristol, UK aut NATIONALLICENCE 773 0- Annals of Surgical Oncology Springer-Verlag 18/3(2011-03-01), 813-823 1068-9265 18:3<813 2011 18 10434 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer