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Comparison of Static Photography and Real Time Digital Video in the Assessment of Aesthetic Outcomes Following Breast Reconstruction

18 Years
Open (Enrolling by invite only)
Breast Neoplasms, Breast Reconstruction

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Trial Information

Comparison of Static Photography and Real Time Digital Video in the Assessment of Aesthetic Outcomes Following Breast Reconstruction

Breast cancer is the commonest cancer to affect women in the UK. Current guidelines state
that; disease permitting, all females due to undergo mastectomy for breast cancer should be
offered reconstruction. This usually takes place in the form of implant based
reconstruction, regional flap based reconstruction +/- implant or free autologous tissue
based reconstruction.

Traditional methods of subjectively assessing the aesthetic outcome of any of the forms of
breast surgery have been shown to be poor and the assessment of immediate reconstructions a
cumbersome task. The qualitative part of the assessment usually relies on standardised
clinical photographs and panel ratings. Four to six photographs are usually taken of the
patient and their reconstruction from different angles. These photographs are then shown to
an expert panel (usually consisting of healthcare professionals familiar with breast

A large degree of both inter and intra-observer bias exists when comparing standardized
photographs. The results from expert assessment of cosmesis often do not correlate to the
patients opinion with regards to the cosmetic outcome of their reconstruction

Due to the static nature of clinical photography it does not capture the effect which
movement and gravity play on a reconstructed breast in comparison to a normal breast.

A large volume of information can be captured from a short digital video clip in comparison
to a single photograph. The potential advantages of digital video assessment over
photography are only beginning to be explored with regards to aesthetics in other fields
associated to medicine.9 However this has never been trialed with regards to breast cancer

We believe that real time digital video footage would be a more valuable tool in the
assessment of breast reconstruction. We believe that there may be more accurate correlations
between patient's satisfaction and panel opinion and that there will be less inter and
intra-observer discordance

Inclusion Criteria:

- Female patient

- Minimum 18 years of age

- Due to attend for Nipple areola complex tattooing

- Previous unilateral breast reconstruction following mastectomy

Exclusion Criteria:

- Male patient

- Bilateral Breast Reconstruction

- Reconstruction less than 1year ago

- Breast reconstruction not following breast cancer excision

Type of Study:


Study Design:

Observational Model: Case-Only, Time Perspective: Cross-Sectional

Outcome Measure:

Inter/Intra observer correlation on cosmetic scale using digital video footage

Outcome Description:

The primary aim of this study is to assess the level of inter and intra rater agreement for the expert panel on each of the 6 questions on the cosmetic outcome of breast reconstruction patients using digital video footage

Outcome Time Frame:

Outcome measure will be assessed approximately 1 year post breast reconstruction

Safety Issue:


Principal Investigator

Adam Gilmour, MBChB, MRCS(Ed)

Investigator Role:

Principal Investigator

Investigator Affiliation:

NHS Greater Glasgow & Clyde


United Kingdom: National Health Service

Study ID:




Start Date:

June 2012

Completion Date:

April 2013

Related Keywords:

  • Breast Neoplasms
  • Breast Reconstruction
  • Breast
  • Reconstruction
  • Breast Neoplasms
  • Neoplasms