Abstract
"Taking less treating better" has been one of the major improvements of breast cancer surgery in the last four decades. The application of this principle translates into equivalent survival of breast cancer conserving treatment (BCT) when compared to mastectomy, with a better cosmetic outcome. While it is relatively easy to evaluate the oncological results of BCT, the cosmetic outcome is more difficult to measure due to the lack of an effective and consensual procedure. The assessment of cosmetic outcome has been mainly subjective, undertaken by a panel of expert observers or/and by patient self-assessment. Unfortunately, the reproducibility of these methods is low. Objective methods have higher values of reproducibility but still lack the inclusion of several features considered by specialists in BCT to be fundamental for cosmetic outcome. The recent addition of volume information obtained with 3D images seems promising. Until now, unfortunately, no method is considered to be the standard of care. This paper revises the history of cosmetic evaluation and guides us into the future aiming at a method that can easily be used and accepted by all, caregivers and caretakers, allowing not only the comparison of results but the improvement of performance. (C) 2014 Wiley Periodicals, Inc.

Abstract
The conservative treatment is now the preferred procedure to treat breast cancer mainly due to better aesthetical results obtained. However, the aesthetic outcome is diverse and very difficult to evaluate, which motivates the research on automatic methodologies. The use of three-dimensional (3D) methodologies is increasing; however, the high cost of the equipment and the need for specialised technicians to operate it are import setbacks. Consequently, the search for affordable and easy to perform equipments is highly desirable. This paper studies the application of a Kinect device in this field, addressing issues related to accuracy, resolution and quality of the data. The paper demonstrates a comparative study of state-of-the-art Super-Resolution (SR) algorithms applied to the Kinect depth data, and the importance to improve the quality of images is stressed. The results demonstrate that it is possible to measure volumetric information and that there is agreement between features and the subjective aesthetic evaluation.

Abstract
Breast-conserving approaches aim to attain better aesthetic results in addition to local control and achieving survival rates equivalent to mastectomy in patients with breast cancer. While the oncologic outcome of breast conservation procedures is easily estimated objectively by disease-free and overall survival rates, the cosmetic outcome has no standard of evaluation. Although breast conservation techniques have been widely studied, different forms of evaluation and heterogeneous working practices have contributed to different aesthetic results. As this scenario suggests, the evaluation of aesthetic results should be mandatory in any institution performing breast cancer treatment, contributing to the improvement of current strategies by enabling the identification of variables which have a significant impact on the final aesthetic result. In the process of assessing cosmetic outcomes there are several important issues that should be considered: which factors have a crucial impact on the cosmetic outcome of Breast Cancer Conservation Treatment (BCCT); which parameters or features should be evaluated in the cosmetic assessment of BCCT; how patients are evaluated; which scales are used in this evaluation; which methods and technological solutions are available for the evaluation of cosmetic results of BCCT. In this paper we try to discuss all these questions, with an emphasis on the objective methods and corresponding technologies used in the aesthetic evaluation of BCCT. The most relevant publications related to the mentioned topics are presented, critically analysed and put in chronological perspective. Current and future trends are also discussed.

Abstract
Background and objective: Cosmetic outcome of breast cancer conservative treatment (BCCT) remains without a standard evaluation method. Subjective methods, in spite of their low reproducibility, continue to be the most frequently used. Objective methods, although more reproducible, seem unable to translate all the subtleties involved in cosmetic outcome. The breast cancer conservative treatment cosmetic results (BCCT. core) software was developed in 2007 to try to overcome these pitfalls. The software is a semi-automatic objective tool that evaluates asymmetry, color differences and scar visibility using patient's digital pictures. The purpose of this work is to review the use of the BCCT. core software since its availability in 2007 and to put forward future developments. Methods: All the online requests for BCCT. core use were registered from June 2007 to December 2014. For each request the department, city and country as well as user intention (clinical use/research or both) were questioned. A literature search was performed in Medline, Google Scholar and ISI Web of Knowledge for all publications using and citing "BCCT.core". Results: During this period 102 centers have requested the software essentially for clinical use. The BCCT. core software was used in 19 full published papers and in 29 conference abstracts. Conclusions: The BCCT. core is a user friendly semi-automatic method for the objective evaluation of BCCT. The number of online requests and publications have been steadily increasing turning this computer program into the most frequently used tool for the objective cosmetic evaluation of BCCT.

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