A cognitive behavioral therapy-based intervention to address body image in patients with facial cancers: Results from a randomized controlled trial.

Objectives: Body image adjustment is a crucial issue for patients with facial cancer, but body image-specific interventions are scarce. We report results of a novel psychotherapeutic intervention to address body image concerns during acute postoperative recovery following facial reconstructive surgery. Our primary aims were to evaluate the intervention's feasibility, acceptability, and efficacy on body image concerns, psychological distress, and quality of life (QOL).

A qualitative assessment of body image in adolescents and young adults (AYAs) with cancer.

Context: Among adolescents and young adults (AYAs), cancer and its treatment can disturb body image in distinct ways compared to younger or older individuals.

Objective: Since AYA body image is not well understood, this study was designed to develop a conceptual framework for body image in AYAs with cancer.

Methods: Concept elicitation interviews were conducted with 36 AYA patients [10 adolescents (15-17 years), 12 emerging adults (18-25 years), 14 young adults (26-39 years)] and health care providers (n = 36).

Characterization of human female breast and abdominal skin elasticity using a bulge test.

Characterization of material properties of human skin is required to develop a physics-based biomechanical model that can predict deformation of female breast after cosmetic and reconstructive surgery. In this paper, we have adopted an experimental approach to characterize the biaxial response of human skin using bulge tests. Skin specimens were harvested from breast and abdominal skin of female subjects who underwent mastectomy and/or reconstruction at The University of Texas MD Anderson Cancer Center and who provided informed consent.

Considering Breast Reconstruction after Mastectomy: A Patient Decision Aid Video and Workbook.

Unlabelled: Women report difficulty understanding and personalizing breast reconstruction information during the complex and time-limited period of cancer treatment planning. Patient decision aids can help patients become well informed, form realistic expectations, prepare to communicate with the surgical team, and be more satisfied with their decision-making process.

Methods: We engaged patients, providers, and stakeholders in a user-centered design process to develop an online patient decision aid video and interactive workbook for breast reconstruction after mastectomy.

Observers' response to facial disfigurement from head and neck cancer.

Objective: Our long-term goal is to develop a normative feedback intervention to support head and neck cancer patients in forming realistic expectations about how other people in non-social group settings will respond to their appearance. This study aimed to evaluate the relationship between observer ratings of facial disfigurement and observer ratings of emotional response when viewing photographs of faces of head and neck cancer patients.

Methods: Seventy-five (75) observers rated their emotional response to each of 144 facial photographs of head and neck cancer patients using the Self-Assessment-Manikin and rated severity of facial disfigurement on a 9-point scale.

Body image dissatisfaction in patients undergoing breast reconstruction: Examining the roles of breast symmetry and appearance investment.

Objective: Reconstruction as part of treatment for breast cancer is aimed at mitigating body image concerns after mastectomy. Although algorithms have been developed to objectively assess breast reconstruction outcomes, associations between objectively quantified breast aesthetic appearance and patient-reported body image outcomes have not been examined. Further, the role of appearance investment in explaining a patient's body image is not well understood.

Mechanical response of human female breast skin under uniaxial stretching.

Skin is a complex material covering the entire surface of the human body. Studying the mechanical properties of skin to calibrate a constitutive model is of great importance to many applications such as plastic or cosmetic surgery and treatment of skin-based diseases like decubitus ulcers. The main objective of the present study was to identify and calibrate an appropriate material constitutive model for skin and establish certain universal properties that are independent of patient-specific variability.

Quantitative Assessment of Breast Cosmetic Outcome After Whole-Breast Irradiation.

Purpose: To measure, by quantitative analysis of digital photographs, breast cosmetic outcome within the setting of a randomized trial of conventionally fractionated (CF) and hypofractionated (HF) whole-breast irradiation (WBI), to identify how quantitative cosmesis metrics were associated with patient- and physician-reported cosmesis and whether they differed by treatment arm.

Methods And Materials: From 2011 to 2014, 287 women aged ≥40 with ductal carcinoma in situ or early invasive breast cancer were randomized to HF-WBI (42.56 Gy/16 fractions [fx] + 10-12.

Computation of breast ptosis from 3D surface scans of the female torso.

Stereophotography is now finding a niche in clinical breast surgery, and several methods for quantitatively measuring breast morphology from 3D surface images have been developed. Breast ptosis (sagging of the breast), which refers to the extent by which the nipple is lower than the inframammary fold (the contour along which the inferior part of the breast attaches to the chest wall), is an important morphological parameter that is frequently used for assessing the outcome of breast surgery. This study presents a novel algorithm that utilizes three-dimensional (3D) features such as surface curvature and orientation for the assessment of breast ptosis from 3D scans of the female torso.

Inferior Breast-Chest Contour Detection in 3-D Images of the Female Torso.

Stereophotogrammetry is finding increased use in clinical breast surgery, both for breast reconstruction after oncological procedures and cosmetic augmentation and reduction. The ability to visualize and quantify morphological features of the breast facilitates pre-operative planning and post-operative outcome assessment. The contour outlining the lower half of the breast is important for the quantitative assessment of breast aesthetics.

Longitudinal analysis of patient-reported outcomes and cosmesis in a randomized trial of conventionally fractionated versus hypofractionated whole-breast irradiation.

Background: The authors compared longitudinal patient-reported outcomes and physician-rated cosmesis with conventionally fractionated whole-breast irradiation (CF-WBI) versus hypofractionated whole-breast irradiation (HF-WBI) within the context of a randomized trial.

Methods: From 2011 to 2014, a total of 287 women with American Joint Committee on Cancer stage 0 to stage II breast cancer were randomized to receive CF-WBI (at a dose of 50 grays in 25 fractions plus a tumor bed boost) or HF-WBI (at a dose of 42.56 grays in 16 fractions plus a tumor bed boost) after breast-conserving surgery.

Salient body image concerns of patients with cancer undergoing head and neck reconstruction.

Background: Patients with cancer undergoing head and neck reconstruction can experience significant distress from alterations in appearance and bodily functioning. We sought to delineate salient dimensions of body image concerns in this patient population preparing for reconstructive surgery.

Methods: Participants completed self-report questionnaires evaluating numerous aspects of body image.

Body image and quality of life of breast cancer patients: influence of timing and stage of breast reconstruction.

Objective: The process of cancer-related breast reconstruction is typically multi-staged and can take months to years to complete, yet few studies have examined patient psychosocial well-being during the reconstruction process. We investigated the effects of reconstruction timing and reconstruction stage on body image and quality of life at specific time points during the breast reconstruction process.

Methods: In this cross-sectional study, 216 patients were grouped into four reconstructive stages: pre-reconstruction, completed stage 1, completed stage 2, and final stages.

Coping and quality of life of patients following microsurgical treatment for breast cancer-related lymphedema.

Breast cancer-related lymphedema is associated with numerous adverse outcomes. This study investigated the extent clinical factors, lymphedema symptoms, lymphedema-related appearance, and coping strategies predicted quality of life. Female patients who underwent microsurgical treatment for lymphedema (n = 54) participated.

Eigen-disfigurement model for simulating plausible facial disfigurement after reconstructive surgery.

Background: Patients with facial cancers can experience disfigurement as they may undergo considerable appearance changes from their illness and its treatment. Individuals with difficulties adjusting to facial cancer are concerned about how others perceive and evaluate their appearance. Therefore, it is important to understand how humans perceive disfigured faces.

3D surface imaging of the human female torso in upright to supine positions.

Three-dimensional (3D) surface imaging of breasts is usually done with the patient in an upright position, which does not permit comparison of changes in breast morphology with changes in position of the torso. In theory, these limitations may be eliminated if the 3D camera system could remain fixed relative to the woman's torso as she is tilted from 0 to 90°. We mounted a 3dMDtorso imaging system onto a bariatric tilt table to image breasts at different tilt angles.

Examining pain, body image, and depressive symptoms in patients with lymphedema secondary to breast cancer.

Objective: Depression and reduced quality of life are often reported in patients with upper-extremity lymphedema secondary to breast cancer treatment. Little is known about how pain and body image influence depression in patients with lymphedema. The current study examined the association of pain intensity and body integrity beliefs with depressive symptoms and the extent to which body image dissatisfaction mediated these associations.

Body image investment in breast cancer patients undergoing reconstruction: taking a closer look at the Appearance Schemas Inventory-Revised.

Breast cancer and its treatment can significantly affect a woman's body image. As such, it would be useful to understand the importance or value these patients place on their appearance. We evaluated the factor structure of the Appearance Schemas Inventory-Revised (ASI-R), a measure of body image investment, with a sample of 356 breast cancer patients undergoing mastectomy and breast reconstruction.

In-vivo quantification of human breast deformation associated with the position change from supine to upright.

Stereophotographic imaging and digital image correlation are used to determine the variation of breast skin deformation as the subject orientation is altered from supine to upright. A change in subject's position from supine to upright can result in significant stretches in some parts of the breast skin. The maximum of the major principal stretch ratio of the skin is different in different subjects and varies in the range of 1.

Body image: a critical psychosocial issue for patients with head and neck cancer.

Increasing attention is being given to evaluating and treating body image difficulties of patients undergoing cancer treatment. Head and neck cancer significantly alters physical appearance and bodily functioning and therefore directly impacts body image. Research involving body image in head and neck cancer patients is growing, and this review considers published findings from 2013 to 2014.

Helping patients make choices about breast reconstruction: a decision analysis approach.

Decision analysis can help breast reconstruction patients and their surgeons to methodically evaluate clinical alternatives and make hard decisions. The purpose of this article is to help plastic surgeons guide patients in making decisions though a case study in breast reconstruction. By making good decisions, patient outcomes may be improved.

Associations between psychosocial functioning and smiling intensity in patients with head and neck cancer.

Increasing attention is being given to developing quantitative measures of facial expression. This study used quantitative facial expression analysis to examine associations between smiling intensity and psychosocial functioning in patients with head and neck cancer (HNC). Smiling intensity of 95 HNC patients was measured using 48 quantitative measures calculated from facial photographs with and without a smile.

Assessing Women's Preferences and Preference Modeling for Breast Reconstruction Decision-Making.

Background: Women considering breast reconstruction must make challenging trade-offs amongst issues that often conflict. It may be useful to quantify possible outcomes using a single summary measure to aid a breast cancer patient in choosing a form of breast reconstruction.

Methods: In this study, we used multiattribute utility theory to combine multiple objectives to yield a summary value using nine different preference models.

Body image screening for cancer patients undergoing reconstructive surgery.

Objectives: Body image is a critical issue for cancer patients undergoing reconstructive surgery, as they can experience disfigurement and functional impairment. Distress related to appearance changes can lead to various psychosocial difficulties, and patients are often reluctant to discuss these issues with their healthcare team. Our goals were to design and evaluate a screening tool to aid providers in identifying patients who may benefit from referral for specialized psychosocial care to treat body image concerns.

Plastic Surgeon Expertise in Predicting Breast Reconstruction Outcomes for Patient Decision Analysis.

Background: Decision analysis offers a framework that may help breast cancer patients make good breast reconstruction decisions. A requirement for this type of analysis is information about the possibility of outcomes occurring in the form of probabilities. The purpose of this study was to determine if plastic surgeons are good sources of probability information, both individually and as a group, when data are limited.