Breast Cancer and Reconstruction: Normative Data for Interpreting the BREAST-Q

Abstract

Background The BREAST-Q is a patient-reported outcome instrument used to evaluate outcomes in patients undergoing breast cancer surgery and reconstruction. Normative values for the BREAST-Q breast cancer modules have not been established, limiting data interpretation. Methods Participants were recruited via the Army of Women, an online community of women (with and without breast cancer), to complete mastectomy, breast conserving therapy (BCT), and reconstruction pre-operative BREAST-Q scales. Inclusion criteria were women aged ≥18 years without a prior history of breast surgery or breast cancer. Analysis included descriptive statistics, a linear multivariate regression, and a comparison of the generated normative data to previously published BREAST-Q findings. Results The BREAST-Q was completed by 1,201 women. Mean age was 54 ±13 years, mean body mass index (BMI) 26 ±6, and 38% (n=455) had a bra cup ≥D. Mean scores for BREAST-Q scales (±standard deviation) were as follows: Satisfaction with Breasts (58 ±18), Psychosocial Well-being (71 ±18), Sexual Well-being (56 ±18), Physical Well-being-Chest (93 ±11), and Physical Well-being-Abdomen (78 ±20). Women with BMI ≥30, cup size ≥D, age <40, and income <$40,000/year reported lower scores. Comparing normative scores to published data in breast cancer patients, Satisfaction with Breasts were higher after autologous reconstruction and lower after mastectomy, Sexual Well-being scores were lower after mastectomy and BCT, and Physical Well-being Chest scores were lower after mastectomy, BCT and reconstruction. Conclusions These are the first published normative scores for the BREAST-Q breast cancer modules, and provide a clinical reference point for the interpretation of data.

Patient reported outcome and cosmetic evaluation following implant-based breast-reconstruction with a titanized polypropylene mesh (TiLOOP® Bra): A prospective clinical study in 269 patients

“…At the 12mFU no difference was detected. These findings are in line with results of a study to gain normative data concerning the Breast-Q on 1201 women without prior history of breast cancer or breast surgery; women with a BMI30 kg/m 2 had lower Breast-Q scores for "satisfaction with breasts", "psychosocial well-being", "sexual well-being", and "physical well-being chest" compared to women with BMI<30 kg/m 2 [20]. Regarding the follow-up after BR, a study by Teo et al [31] also did not find an influence of the BMI on any Breast-Q scale.…”

“…The latter was also true for patients 40 years, while these patients showed higher scores for "satisfaction with breasts" and "sexual well-being", respectively. Mundy et al [20] showed that patients >40 years had higher baseline scores for "psychosocial well-being", "sexual well-being" and "physical well-being chest". This finding could be confirmed by the present study.…”

“…PRO was evaluated regarding patients' age at study inclusion. Patients were stratified in the groups 40 years (46 patients) and >40 years (164 patients) in order to achieve comparability to previously published studies [20,21]. Patients >40 years showed significantly lower scores at 12mFU compared to pre-OP for "satisfaction with breasts" (pre-OP: 66.6 ± 22.7,12mFU: 59.8 ± 19.0; p < 0.01) (Fig.…”

Knowledge gaps in oncoplastic breast surgery

“…It is rigorously developed, validated, specific to breast surgery and available in several languages. [64][65][66] Despite there being no universally accepted approach for determining the clinical significance of health-related QoL data, first estimates on minimally important differences for the BREAST-Q scores have now been published and these allow sample size calculations for clinical trials. 67 Clinical indicators of risk in OPS are likely to focus on factors such as rates of complications and return to the operating room as well as delays to start of adjuvant treatments or return to work.…”

Two-Staged Implant-Based Breast Reconstruction: A Long-Term Outcome Study in a Young Population

“…Breast reconstruction following mastectomy has been shown to improve the quality of life as well as the social and psychological satisfaction of female patients undergoing mastectomy [1,2,3,4] Several options exist to reconstruct the breast such as autologous, implant-based reconstruction or a combination of both [5,6]. Implant-based breast reconstruction (IBR) remains the most common reconstructive approach in the United States and worldwide among women undergoing mastectomy [7,8,9,10].…”