Using BREAST-Q Tool

Quality of life was measured using the BREAST-Q questionnaire. This validated instrument is specific for evaluating patient reports on breast surgery outcomes and is calibrated to detect differences over time between specific procedure groups and patients.2 The researchers report that the BREAST-Q has substantially improved clinicians’ understanding of how patients regard the outcomes of their breast reconstruction procedure. Participants completed the BREAST-Q questionnaire up to 90 days prior to surgery, and at 1, 2, 3, and 4 years after surgery.

Five areas of the BREAST-Q reconstruction module were evaluated: satisfaction with breasts, sexual well-being, psychosocial well-being, physical well-being of the chest, and physical well-being of the abdomen. Using conversion tables, responses were converted on a scale of 0 to 100, where the higher numbers represented greater satisfaction or quality of life.

Trends in Response Rate

Two years after their breast reconstruction, 1217 patients (60.5%) completed the BREAST-Q survey. But response rates diminished in the later years of the study. At 3 years postreconstruction, 422 survivors (21.0%) completed the questionnaire, and at 4 years, 205 (10.2%) completed the questionnaire.1

Physical well-being was rated higher in the breast area 2 years after autologous reconstruction but worse in the abdominal area compared with responses from those who underwent implant reconstruction. Survivors who had undergone autologous reconstruction reported a high level of satisfaction with their breasts and with their quality of life, as demonstrated by their psychosocial, physical, and sexual well-being scores. However, abdominal well-being scores in this group worsened during the acute postoperative period from baseline to 1 year and did not return to that level even 2 years after breast reconstruction.

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By contrast, the women who underwent implant-based reconstruction were initially satisfied with their breasts and their sexual well-being, but a decrease in scores indicated their satisfaction gradually deteriorated over time. 1

BREAST-Q scoring demonstrated that patients who underwent autologous reconstruction reported significantly greater satisfaction with their breasts (BREAST-Q score difference, 7.94), sexual well-being (difference, 5.53), and psychosocial well-being (difference, 3.23) at 2 years compared with those who underwent implant reconstruction.