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Published in: BMC Cancer 1/2017

Open Access 01-12-2017 | Study protocol

TUmor-volume to breast-volume RAtio for improving COSmetic results in breast cancer patients (TURACOS); a randomized controlled trial

Authors: M. Lagendijk, E. L. Vos, A. H. J. Koning, M. G. M. Hunink, J. P. Pignol, E. M. L. Corten, C. de Monye, C. H. M. van Deurzen, J. H. van Dam, W. W. Vrijland, C. M. E. Contant, C. Verhoef, W. van Lankeren, L. B. Koppert

Published in: BMC Cancer | Issue 1/2017

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Abstract

Background

Cosmetic result following breast conserving surgery (BCS) for cancer influences quality of life and psychosocial functioning in breast cancer patients. A preoperative prediction of expected cosmetic result following BCS is not (yet) standard clinical practice and therefore the choice for either mastectomy or BCS is still subjective. Recently, we showed that tumour volume to breast volume ratio as well as tumour location in the breast are independent predictors of superior cosmetic result following BCS. Implementation of a prediction model including both factors, has not been studied in a prospective manner. This study aims to improve cosmetic outcome by implementation of a prediction model in the treatment decision making for breast cancer patients opting for BCS.

Methods/design

Multicentre, single-blinded, randomized controlled trial comparing standard preoperative work-up to a preoperative work-up with addition of the prediction model. Tumour volume to breast volume ratio and tumour location in the breast will be used to predict cosmetic outcome in invasive breast cancer patients opting for BCS. Three dimensional (3D)-ultrasonography will be used to measure the tumour volume to breast volume ratio needed for the prediction model. Sample size was estimated based on a 14% improvement in incidence of superior cosmetic result one year after BCS (71% in the control group versus 85% in the intervention group). Primarily cosmetic outcome will be evaluated by a 6-member independent panel. Secondary endpoints include; (1) patient reported outcome measured by BREAST-Q, EORTC-QLQ-C30/BR23 and EQ-5D-5 L (2) cosmetic outcome as assessed through the BCCT.core software, (3) radiation-induced reaction (4) surgical treatment performed, (5) pathological result and (6) cost-effectiveness. Follow-up data will be collected for 3 years after surgery or finishing radiotherapy.

Discussion

This randomized controlled trial examines the value of a preoperative prediction model for the treatment-decision making. It aims for a superior cosmetic result in breast cancer patients opting for BCS. We expect improvement of patients’ quality of life and psychosocial functioning in a cost-effective way.

Trial registration

Prospectively registered, February 17th 2015, at ‘Nederlands Trialregister - NTR4997’.
Appendix
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Metadata
Title
TUmor-volume to breast-volume RAtio for improving COSmetic results in breast cancer patients (TURACOS); a randomized controlled trial
Authors
M. Lagendijk
E. L. Vos
A. H. J. Koning
M. G. M. Hunink
J. P. Pignol
E. M. L. Corten
C. de Monye
C. H. M. van Deurzen
J. H. van Dam
W. W. Vrijland
C. M. E. Contant
C. Verhoef
W. van Lankeren
L. B. Koppert
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Cancer / Issue 1/2017
Electronic ISSN: 1471-2407
DOI
https://doi.org/10.1186/s12885-017-3280-y

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