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，大多数乳腺癌患者可以接受保乳治疗，以达到局部肿瘤控制。然而，手术结果在美学和功能结果方面有很大差异。为了改善这些终点方面的不同手术技术，需要临床评分形式的适当测量工具，以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）定义了评估患者个人观点的标准方法。该问卷通过22个详细项目（分为3个分量表）纳入了保乳治疗的具体方面。然而，三个分量表对应的分数并不是最佳的，原因有几个。一方面，存在两种不同的分数，其测量功能结果的高度相关方面，这是不直观的，另一方面，分数不能很好地区分好结果和坏结果。此外，评分的再现性不是最佳的，并且与生活质量的高度相关方面仅存在中等相关性。这些问题可以解释为一个次优选择的基础分解和得分建设算法。一个有效和可靠的测量美学和功能的结果，因此目前是不可能的。这个DFG项目的目的是开发两个优化的分数，用于测量保乳治疗后的美学和功能的结果，是基于现有的问卷BCTOS。此外，将推导出不同患者人群的参考值，并将实现基于网络的界面，以简化新评分的计算。在第二步中，我们描述了对美学结果变化的敏感性，以确定短期和长期发展中不良美学结果的预测因素。这是一个妇科学和医学生物统计学的跨学科项目，与患者高度相关。积极的资助可以大大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.