Nonresponse data in sexual well‐being among breast reconstruction patients—who are we overlooking?

Abstract

BackgroundMissing data can affect the representativeness and accuracy of survey results, and sexual health‐related surveys are especially at a higher risk of nonresponse due to their sensitive nature and stigma. The purpose of this study was to evaluate the proportion of patients who do not complete the BREAST‐Q Sexual Well‐being relative to other BREAST‐Q modules and compare responders versus nonresponders of Sexual Well‐being. We secondarily examined variables associated with Sexual Well‐being at 1‐year.MethodsA retrospective analysis of patients who underwent breast reconstruction from January 2018 to December 2021 and completed any of the BREAST‐Q modules postoperatively at 1‐year was performed.ResultsThe 2941 patients were included. Of the four BREAST‐Q domains, Sexual Well‐being had the highest rate of nonresponse (47%). Patients who were separated (vs. married, OR = 0.69), whose primary language was not English (vs. English, OR = 0.60), and had Medicaid insurance (vs. commercial, OR = 0.67) were significantly less likely to complete the Sexual Well‐being. Postmenopausal patients were significantly more likely to complete the survey than premenopausal patients. Lastly, autologous reconstruction patients were 2.93 times more likely to respond than implant‐based reconstruction patients (p < 0.001) while delayed (vs. immediate, OR = 0.70, p = 0.022) and unilateral (vs. bilateral, OR = 0.80, p = 0.008) reconstruction patients were less likely to respond. History of psychiatric diagnosis, aromatase inhibitors, and immediate breast reconstruction were significantly associated with lower Sexual Well‐being at 1‐year.ConclusionSexual Well‐being is the least frequently completed BREAST‐Q domain, and there are demographic and clinical differences between responders and nonresponders. We encourage providers to recognize patterns in nonresponse data for Sexual‐Well‐being to ensure that certain patient population's sexual health concerns are not overlooked.