Development of two optimized scores for patient-individual measurement of the aesthetic and functional result after breast conserving therapy of breast cancer with the aim to optimize therapy evaluation: an interdisciplinary project of gynecology and medi

事实上，大多数乳腺癌患者都可以通过保乳治疗来实现局部肿瘤控制。然而，手术的结果在美学和功能结果上有很大的不同。为了改进针对这些终点的不同手术技术，需要足够的临床评分形式的测量工具，以允许有效和可靠地测量美学和功能结果。目前，BCTOS问卷(乳腺癌治疗结果量表)定义了评估患者个体视角的标准方法。这份问卷包含了保乳治疗的具体方面，包括22个详细项目，分为三个子量表。然而，由于几个原因，这三个分量表对应的分数并不是最理想的。一方面，存在两个不同的分数，它们衡量的是不直观的功能结果的高度相关的方面，另一方面，分数不能很好地区分好的和不好的结果。此外，得分的重复性并不理想，与高度相关的生活质量方面只存在中等程度的相关性。这些问题可以通过基本因式分解和分数构建算法的次优选择来解释。因此，目前尚不可能对美容效果和功能效果进行有效和可靠的测量。本DFG项目的目的是在现有问卷BCTOS的基础上，为保乳治疗后的美容效果和功能效果的测量开发两个优化的评分。此外，将得出不同患者群体的参考值，并将实施基于网络的界面，以简化新分数的计算。在第二步中，我们描述审美结果对变化的敏感性，以确定在短期和长期发展中不良审美结果的预测因素。这是一个具有高度患者相关性的妇科学和医学生物统计学的跨学科项目。一笔积极的赠款可以极大地改善乳腺癌治疗领域的研究。

Actually, most patients with breast cancer can be treated with breast conserving therapy in order to achieve local tumor control. However, the results of surgery differ considerably with respect to the aesthetic and the functional outcome. To improve the different operation techniques with respect to these endpoints, adequate measurement instruments in form of clinical scores are needed that allow a valid and reliable measurement of the aesthetic and the functional result. At the moment, the BCTOS questionnaire (Breast Cancer Treatment Outcome Scale) defines the standard approach to assess the individual perspective of the patient. This questionnaire incorporates specific aspects of breast conserving therapy by means of 22 detailed items which are divided into three subscales. However, the scores corresponding to the three subscales are not optimal for several reasons. At the one hand, there exist two different scores that measure highly related aspects of the functional result which is not intuitive, at the other hand the scores do not differentiate well between good and bad results. In addition, the reproducibility of the scores is not optimal and there only exist a medium correlation to highly related aspects of quality of life. These problems can be explained by a suboptimal choice of the underlying factorization and the score building algorithms. A valid and reliable measurement of aesthetic and functional results is therefore not possible at present.The aim of this DFG-project is to develop two optimized scores for the measurement of the aesthetic and functional results after breast conserving therapy that are based on the existing questionnaire BCTOS. Moreover, reference values for different patient populations will be derived and a web based interface to simplify the calculation of the new scores will be implemented. In a second step, we describe the sensitivity to changes of the aesthetic result in order to identify predictors for a bad aesthetic result in the short and long term development.This is an interdisciplinary project of gynecology and medical biometry with a highly patient relevant topic. A positive grant could considerably improve the research in the field of breast cancer therapy.