BREAST-Q Outcomes before and after Bilateral Reduction Mammaplasty

Wampler, Ariel T.; Powelson, Ian A.; Homa, Karen; Freed, Gary L.

doi:10.1097/prs.0000000000007605

Cited by 28 publications

(30 citation statements)

References 44 publications

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“…A bilateral procedure was significantly associated with “Psychosocial well-being” at 5 years after breast surgery. Several studies focusing on bilateral breast operations have concluded that “Psychosocial well-being” after surgery significantly improves compared to the preoperative level ( 54 , 55 ). These findings suggest that patients who underwent bilateral reconstruction were more satisfied due to improved symmetry and a superior aesthetic appearance.…”

Section: Discussionmentioning

confidence: 99%

Long-Term Patient Satisfaction and Quality of Life Following Breast Reconstruction Using the BREAST-Q: A Prospective Cohort Study

et al. 2022

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BackgroundBreast reconstruction is a promising surgical technique to improve health-related quality of life (HRQoL) in patients with breast cancer. However, the long-term risk factors associated with HRQoL after breast surgery are still unclear. Our aim was to evaluate breast satisfaction and HRQoL following breast reconstruction to identify clinical factors associated with each domain of BREAST-Q in the long-term.MethodsPatient-reported BREAST-Q outcomes were analyzed 1 and 5 years after breast reconstruction in a single-blinded, prospective study. Multiple regression analysis was performed to identify the risk and protective factors associated with BREAST-Q scores. These scores at 1 and 5 years were also compared across three types of operation: mastectomy only, tissue expander/implant (TE/Imp), and a deep inferior epigastric perforator (DIEP) flap.ResultsSurveys were completed by 141 subjects after 1 year and 131 subjects after 5 years. Compared to mastectomy only, breast reconstruction was significantly associated with greater “Satisfaction with breasts” (TE/Imp, p < 0.001; DIEP, p < 0.001) and “Psychosocial well-being” (TE/Imp, p < 0.001; DIEP, p < 0.001), higher body mass index (BMI) resulted in lower “Satisfaction with breasts” (p = 0.004), and a history of psychiatric or neurological medication was significantly associated with “Physical well-being” at 1-year postoperatively (p = 0.02). At 5 years, reconstructive procedures were significantly positively associated with greater “Satisfaction with breasts” (TE/Imp, p < 0.001; DIEP, p < 0.001) and “Psychosocial well-being” (TE/Imp, p = 0.03; DIEP, p < 0.001), and a bilateral procedure was a significant risk factor for lower “Psychosocial well-being” (p = 0.02).ConclusionsThe results of this study show that breast reconstruction improves “Satisfaction with Breasts” and “Psychosocial well-being” compared to mastectomy. Among all three types of operation, DIEP gave the best scores at 5 years postoperatively. Thus, autologous reconstruction is recommended for promotion of long-term HRQoL after breast surgery.

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Section: Discussionmentioning

confidence: 99%

Long-Term Patient Satisfaction and Quality of Life Following Breast Reconstruction Using the BREAST-Q: A Prospective Cohort Study

et al. 2022

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“…Compared with a previous study on breast hypertrophy in Region Västra Götaland , the normative values were considerably higher in all domains (Table 1 ). Similarly, US studies on patients with beast hypertrophy have revealed lower scores (mean 20 to 46) than the norms [ 5 , 18 ]. Nonetheless, these studies were performed in patients who had actively requested breast surgery and they were therefore per definition dissatisfied with their breasts.…”

Section: Discussionmentioning

confidence: 99%

“…Several PROMs have been developed for breast hypertrophy, of which BREAST-Q is the most widely used [1,2]. PROMs consistently show that patients are more satisfied with their breasts and have a higher quality of life (QoL) after a breast reduction [3][4][5]. This effect can be seen both in breast reductions performed in the public health care system [3][4][5] as well as in privately financed aesthetic surgery [6,7], which makes it difficult to use improvement in patient satisfaction and QoL as indicators that the surgery should be performed in the publicly financed health care system [1].…”

Section: Introductionmentioning

confidence: 99%

“…PROMs consistently show that patients are more satisfied with their breasts and have a higher quality of life (QoL) after a breast reduction [3][4][5]. This effect can be seen both in breast reductions performed in the public health care system [3][4][5] as well as in privately financed aesthetic surgery [6,7], which makes it difficult to use improvement in patient satisfaction and QoL as indicators that the surgery should be performed in the publicly financed health care system [1]. One aspect to consider when deciding if an operation should be rationed or not could be to evaluate if the woman's breast related satisfaction and QoL is within statistical normality [8].…”

Section: Introductionmentioning

confidence: 99%

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Swedish Normative Scores for the BREAST-Q Reduction/Mastopexy Module

et al. 2022

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Background Norm values for patient reported outcomes, that is knowledge about how the general population of women rate their breast-related satisfaction and quality of life, are necessary to interpret the meaning of scores. The aims of this study were to create Swedish normative values for the BREAST-Q reduction/mastopexy module and to describe what healthy women are most satisfied/dissatisfied with regarding their breasts. Methods A random sample of 400 women aged 18-80, currently living in Region Västra Götaland, were sent BREAST-Q reduction/mastopexy. Descriptive data are presented. Results One hundred and forty-six women answered the questionnaire (36.5%). Mean total scores ranged from 48 to 78. No clear changes in scores could be seen with age and women with a high BMI seem to be less satisfied with their breasts. The participants were most satisfied with the appearance of the breasts when dressed, the appearance in the mirror dressed, the shape of the breasts with bra, and symmetry of size and most dissatisfied with appearance in the mirror naked and the shape of the breasts without a bra. Thirty to forty-five per cent of healthy women never or almost never feel sexually attractive. Among physical symptoms often described in breast hypertrophy, the most common among healthy women were lack of energy, pain in the neck, arms and shoulders, headache and difficulty performing intense physical activity. Conclusion The norms for BREAST-Q reduction/mastopexy add another piece to the puzzle to what constitutes normal breast satisfaction and how surgical outcomes can be evaluated. Level of Evidence IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

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“…Breast reduction or reduction mammaplasty offers relief from both physical and psychological macromastia-associated symptoms. Patients who underwent breast reduction due to macromastia felt overall satisfaction and symptomatic relief [ 2 , 3 , 5 , 6 , 7 ]. Numerous complications have been identified regarding breast reduction, but in most cases major complications are rare [ 6 , 8 , 9 , 10 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

Return to Work after Breast Reduction: A Comparative Study

Holopainen

Oranges

Summa

et al. 2023

JCM

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(1) Background: Breast hypertrophy is a prevalent condition among women worldwide, which can affect different aspects of their quality of life. Uncertainty exists in the medical literature about recommendations for return to work after reduction mammaplasty procedures. The aim of this study was to assess the return to work after reduction mammaplasty for women with breast hypertrophy. (2) Methods: A retrospective cohort study composed of chart review of all reduction mammaplasties performed at a single institution due to breast hypertrophy was considered. Patients not in working life were excluded. Patients were divided into two groups based on the sick leave duration: normal versus prolonged. Prolonged sick leave time was defined as times greater than the 75th percentile for the respective sample data. Demographic and comorbidity data were secondary predictor variables. The primary outcome measure was the occurrence of prolonged sick leave. Secondary endpoints were specific wound healing complications and late complications. We further compare postoperative complications between patients who received a sick leave of 3 weeks versus the other patient cohort. (3) Results: From a total of 490 patients, 407 of them were employed at intake. Mean time to working return after reduction mammaplasty was 4.0 ± 0.9 weeks. Prolonged sick leave occurred in 77 patients and its mean duration was 5.5 ± 0.9 weeks. No differences in age, preoperative BMI, smoking, comorbidities, number of children or use of herbal supplements were detected. Significantly increased intraoperative blood loss occurred in the group who received prolonged sick leave (328.3 mL vs. 279.2 mL, p = 0.031). Postoperative complications were significantly higher in the group who experienced a prolonged sick leave (26.5% vs. 11.2%, p < 0.001), particularly infections and wound dehiscence incidences. No differences in late complications were detected (>30 days, 6.5% vs. 7.6%, p = 0.729). When comparing patients who received a 3 week sick leave with the rest of cohort, blood loss was significantly higher in the group who had a longer sick leave (230.9 mL vs. 303.7 mL, p < 0.001). (4) Conclusions: The occurrence of postoperative complications increased the patients’ return to work time. Comorbidities and preoperative parameters did not affect the length of sick leave. It appears reasonable to suggest a recovery period of approximately 3 weeks, subject to individual variations. An increased intraoperative blood loss might predict a prolonged sick leave.

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BREAST-Q Outcomes before and after Bilateral Reduction Mammaplasty

Cited by 28 publications

References 44 publications

Long-Term Patient Satisfaction and Quality of Life Following Breast Reconstruction Using the BREAST-Q: A Prospective Cohort Study

Long-Term Patient Satisfaction and Quality of Life Following Breast Reconstruction Using the BREAST-Q: A Prospective Cohort Study

Swedish Normative Scores for the BREAST-Q Reduction/Mastopexy Module

Return to Work after Breast Reduction: A Comparative Study

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