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131. Kongress der Deutschen Gesellschaft für Chirurgie

Deutsche Gesellschaft für Chirurgie

25.03. - 28.03.2014, Berlin

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Subjective and Objective Assessment of the Female Breast after Reconstruction

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  • Helga Henseler - Medizinische Hochschule Hannover, Plastische Chirurgie, Hannover
  • Joanna Smith - Medizinische Hochschule Hannover, Plastische Chirurgie, Hannover
  • Adrian Bowman - Medizinische Hochschule Hannover, Plastische Chirurgie, Hannover
  • Balvinder Khambay - Glasgow Dental Hospital and School, Department of Dentistry, Glasgow
  • Xiangyang Ju - Glasgow Dental Hospital and School, Department of Dentistry, Glasgow
  • Ashraf Ayoub - Glasgow Dental Hospital and School, Department of Dentistry, Glasgow
  • Arup Ray - Glasgow Royal Infirmary, Canniesburn Plastic Srugery Unit, Glasgow

Deutsche Gesellschaft für Chirurgie. 131. Kongress der Deutschen Gesellschaft für Chirurgie. Berlin, 25.-28.03.2014. Düsseldorf: German Medical Science GMS Publishing House; 2014. Doc14dgch546

doi: 10.3205/14dgch546, urn:nbn:de:0183-14dgch5466

Published: March 21, 2014

© 2014 Henseler et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

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Introduction: The results of breast reconstruction surgery were examined by subjective and objective method and a comparison was conducted.

Material and methods: Breast capture was performed by validated 3D imaging method in forty-four patients after immediate unilateral breast reconstruction procedures with solely the extended latissimus dorsi flap. Additionally standardized 2D photographs were obtained and breast symmetry was subjectively evaluated by six experts. An error study was conducted. By statistical Procrustes analysis an objective asymmetry score was obtained and compared to the subjective assessment.

Results: The inter-observer agreement was good or substantial in the subjective assessment. There was moderate agreement on the controls and fair to substantial intra-observer agreement. The reconstructed breast showed a significantly smaller volume compared to the opposite side in the objective assessment. The average asymmetry score was 0.052, ranging from 0.019 to 0.136. There was a highly significant relationship between the two scores when comparing the subjective and objective method.

Conclusion: Subjective breast assessment lacked accuracy and reproducibility.

This was the first error study of subjective breast assessment versus an objective validated 3D imaging method based on true 3D parameters.

The established subjective method of breast assessment and new validated objective method showed a substantive agreement, which supported the value of the later.