الفهرس 
Evaluation of cosmesisOnly 14 pages are availabe for public view
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Abstract
Breast cancer is one of the most frequently diagnosed cancers in women worldwide, it accounts for 26 % of all malignancies in women and it’s the most common cause of cancer death in women.
During the second half of the 20th century, more limited operations were promoted, based on suggestions that less radical surgery might be just as effective as the more extensive operations then performed.
It is well accepted that complete removal of tumor is necessary, however, there is a considerable debate regarding what margin of normal tissue surrounding the tumor constitutes a negative margin.
In recent years, however, sentinel lymph node biopsy (SLNB) has emerged as an alternative to ALND and has become the standard treatment for axillary staging in most patients with clinically node-negative breast cancer on clinical examination, ultrasound and/or fine needle aspiration cytology
In an attempt to optimize the balance between the risk of local recurrence and cosmetic results, new surgical technique called “oncoplastic” procedures that combine the principles of surgical oncology and plastic surgery have been introduced in recent years. It allows resection of a greater amount of breast tissue and safer margins without compromising the cosmetic result.
The main purposes of breast cancer RT are preventing loco regional recurrence, preventing hot and cold regions of dose between the adjacent areas, creation of adequate dose distribution at the peripheral lymphatic; minimizing irradiation of lung, heart, and organs at risk; maximum protection of the mediastinal tissues; cosmetically acceptable results; and providing applicable and easily repeatable setup conditions.
Several factors affect the cosmetic outcome like the patient’s position, type of the machine used, the technique of radiotherapy, whether a boost was used or not, the fractionation schedual, the irradiated field whether WBI or APBI and the lymphnodes irradiaton.
Also chemotherapy has an important role in treatment of breast cancer but it can cause radiation recall that may negatively affect cosmesis.Depending on severity, cutaneous radiation recall may be characterized by one or more dermatologic symptoms that can range from mild rash, dry desquamation and/or pruritus, to symptoms that are increasingly painful and may include swelling/edema, vesicles, maculopapular eruptions, and papules. In the most severe cases, ulceration and skin necrosis can occur.
There are different methods for aesthetic evaluation of BCT can be divided into subjective and objective. Subjective methods include patient self-evaluation, evaluation by a single observer, or a panel of observers. Objective methods involve several different types of quantifications. For both groups of methods the evaluation can be carried out on the patient or by means of photographs (prints, slides or digital images).