Quantitative clinical photography for managing the quality of life concerns arising from appearance change resulting from breast cancer and its treatment




Nicklaus, Krista Marie

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Patients who experience appearance change resulting from breast cancer and its treatment face a variety of quality of life challenges related to these changes over the course of their cancer journey, such as decisional conflict, decisional regret, and anxiety. As more women become breast cancer survivors, more research and tools are needed to address these needs and challenges so that patients are better equipped to find their new normal after cancer. Clinical photography is commonly used to document appearance change but is under-utilized as a resource to inform patients and providers, especially quantitative data from clinical photographs. This dissertation presents several novel contributions that use clinical photographs to provide patients, providers, and other stakeholders with information that can be used to improve quality of life. Highlights of the major contributions in this dissertation are: 1) a patient-specific recommender system for appearance counseling that identifies photographs of the reconstruction outcomes of prior patients for counseling a current patient, 2) the first analysis of the variety and quality of breast reconstruction photographs available on the Internet, which may influence patient expectations, and 3) the first study of patient preferences for appearance outcomes as opposed to patient expectations. In addition, we include research in the areas of clinical photography to improve radiation oncology decision making, breast reconstruction surgical decision making, and survivorship needs assessment. The studies presented in this dissertation lay the groundwork for many exciting future endeavors to continue to utilize clinical photography and new technologies for the improvement of quality of life of concerns related to appearance change resulting from breast cancer and its treatment.


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