Applanation tonometry after breast conservation - is texture the missing link?
Association of Breast Surgery ePoster Library. O'Connell R. 05/15/17; 166229; P160
Rachel O'Connell
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Abstract
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Introduction
Studies often show divergence between patient-reported outcome measures (PROMs) and clinicians' evaluation of outcome after breast conserving therapy (BCT). The hypothesis was that firmness of the breast, which is not well seen in photographs, may partly explain this discrepancy. The aim was to use applanation tonometry (placing a weighted Perspex disc on the breast and measuring the contact area) to document the compressibility and to correlate that with PROMs (BREAST-Q BCT module), in particular the questions relating to breast texture.
Methods
Ethical approval was obtained. Women who had unilateral BCT 1-6 years ago were recruited. Participants completed the BREAST-Q and underwent applanation tonometry. The contact area was expressed as a ratio: treated/un-treated breast. Pearson's correlation and ANOVA tests were used to evaluate association.
Results
175 women participated. Mean age was 64yrs (SD=10.3). Time from surgery was 35.6 months (SD=18.1). Mean applanation tonometry ratio was 0.89 (SD=0.19). Median 'Satisfaction with breasts' was 68 (IQR=56-80). There was a weak correlation (0.198) between applanation tonometry and “satisfaction with breasts”. There was no correlation with “effect of radiotherapy” or the sub-questions “how your lumpectomy breast sits/hangs” or “how much you are bothered by the irradiated skin feeling thick”.
Conclusions
While texture of the treated breast may impact on satisfaction, this was not shown in this study. Either the compressibility measurement technique was not sufficiently accurate or the PROMs questions are not sensitive enough to detect this. Alternative methods such as compressibility read-outs from mammography should be explored as objective measures of texture as this is an important outcome of surgery and radiotherapy.
Studies often show divergence between patient-reported outcome measures (PROMs) and clinicians' evaluation of outcome after breast conserving therapy (BCT). The hypothesis was that firmness of the breast, which is not well seen in photographs, may partly explain this discrepancy. The aim was to use applanation tonometry (placing a weighted Perspex disc on the breast and measuring the contact area) to document the compressibility and to correlate that with PROMs (BREAST-Q BCT module), in particular the questions relating to breast texture.
Methods
Ethical approval was obtained. Women who had unilateral BCT 1-6 years ago were recruited. Participants completed the BREAST-Q and underwent applanation tonometry. The contact area was expressed as a ratio: treated/un-treated breast. Pearson's correlation and ANOVA tests were used to evaluate association.
Results
175 women participated. Mean age was 64yrs (SD=10.3). Time from surgery was 35.6 months (SD=18.1). Mean applanation tonometry ratio was 0.89 (SD=0.19). Median 'Satisfaction with breasts' was 68 (IQR=56-80). There was a weak correlation (0.198) between applanation tonometry and “satisfaction with breasts”. There was no correlation with “effect of radiotherapy” or the sub-questions “how your lumpectomy breast sits/hangs” or “how much you are bothered by the irradiated skin feeling thick”.
Conclusions
While texture of the treated breast may impact on satisfaction, this was not shown in this study. Either the compressibility measurement technique was not sufficiently accurate or the PROMs questions are not sensitive enough to detect this. Alternative methods such as compressibility read-outs from mammography should be explored as objective measures of texture as this is an important outcome of surgery and radiotherapy.
Introduction
Studies often show divergence between patient-reported outcome measures (PROMs) and clinicians' evaluation of outcome after breast conserving therapy (BCT). The hypothesis was that firmness of the breast, which is not well seen in photographs, may partly explain this discrepancy. The aim was to use applanation tonometry (placing a weighted Perspex disc on the breast and measuring the contact area) to document the compressibility and to correlate that with PROMs (BREAST-Q BCT module), in particular the questions relating to breast texture.
Methods
Ethical approval was obtained. Women who had unilateral BCT 1-6 years ago were recruited. Participants completed the BREAST-Q and underwent applanation tonometry. The contact area was expressed as a ratio: treated/un-treated breast. Pearson's correlation and ANOVA tests were used to evaluate association.
Results
175 women participated. Mean age was 64yrs (SD=10.3). Time from surgery was 35.6 months (SD=18.1). Mean applanation tonometry ratio was 0.89 (SD=0.19). Median 'Satisfaction with breasts' was 68 (IQR=56-80). There was a weak correlation (0.198) between applanation tonometry and “satisfaction with breasts”. There was no correlation with “effect of radiotherapy” or the sub-questions “how your lumpectomy breast sits/hangs” or “how much you are bothered by the irradiated skin feeling thick”.
Conclusions
While texture of the treated breast may impact on satisfaction, this was not shown in this study. Either the compressibility measurement technique was not sufficiently accurate or the PROMs questions are not sensitive enough to detect this. Alternative methods such as compressibility read-outs from mammography should be explored as objective measures of texture as this is an important outcome of surgery and radiotherapy.
Studies often show divergence between patient-reported outcome measures (PROMs) and clinicians' evaluation of outcome after breast conserving therapy (BCT). The hypothesis was that firmness of the breast, which is not well seen in photographs, may partly explain this discrepancy. The aim was to use applanation tonometry (placing a weighted Perspex disc on the breast and measuring the contact area) to document the compressibility and to correlate that with PROMs (BREAST-Q BCT module), in particular the questions relating to breast texture.
Methods
Ethical approval was obtained. Women who had unilateral BCT 1-6 years ago were recruited. Participants completed the BREAST-Q and underwent applanation tonometry. The contact area was expressed as a ratio: treated/un-treated breast. Pearson's correlation and ANOVA tests were used to evaluate association.
Results
175 women participated. Mean age was 64yrs (SD=10.3). Time from surgery was 35.6 months (SD=18.1). Mean applanation tonometry ratio was 0.89 (SD=0.19). Median 'Satisfaction with breasts' was 68 (IQR=56-80). There was a weak correlation (0.198) between applanation tonometry and “satisfaction with breasts”. There was no correlation with “effect of radiotherapy” or the sub-questions “how your lumpectomy breast sits/hangs” or “how much you are bothered by the irradiated skin feeling thick”.
Conclusions
While texture of the treated breast may impact on satisfaction, this was not shown in this study. Either the compressibility measurement technique was not sufficiently accurate or the PROMs questions are not sensitive enough to detect this. Alternative methods such as compressibility read-outs from mammography should be explored as objective measures of texture as this is an important outcome of surgery and radiotherapy.
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