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Quality of Life after Breast Reduction Surgery A 10 year Retrospective Analysis Utilizing the Breast Q Questionnaire: Does breast size matter
Marco A. Gonzalez, MD1, Laurence T. Glickman, MD1, Tana Egodage, MD1, Jonathan Tan, MD MPH2, Roger Simpson, MD, MBA1.
1NUMC/Long Island Plastic Surgial Group, 200 Carman Ave, NY, USA, 2Stony Brook University Hospital, Stony Brook, NY, USA.
Patient reported outcome studies are extremely valuable. We hypothesize that breast reduction surgery has a high satisfaction rate, and that BMI, and the amount of breast tissue removed would not alter this outcome. The purpose of this study was to determine if there is an improvement in Quality of life in patients undergoing breast reduction surgery, and whether breast volume or patient size influences this outcome.
A retrospective chart review was performed on 600 consecutive patients at a single institution from (2000-2010). Patients were mailed The Breast Q questionnaire to complete, and then were followed by a telephone call. Demographic, surgical and clinical data were collected and entered into a data base. Descriptive Statistical analysis were conducted using SAS Software version 9.1.3 with statistical significance determined at p<0.05.
A total of 178 surveys were returned and included in our study. (a response rate of 29.6%) Patient data included a mean BMI of 28.3 ± 4.6 (kg/m2), and mean total amount of breast tissue removed of 1220.9 ± 665.4 (grams). The primary indications for patients having breast surgery were for: symptomatic macromastia (85%), asymmetry (5.6%), and for cosmesis (2.5%). The Breast Q questionnaire demonstrated patients overwhelmingly agreed that they were satisfied with their breast surgery. The mean response was 2.8 with a standard deviation of 0.47 (where 1=disagree; 2 = somewhat agree; 3 = definitely agree). Patient BMI and total amount of breast tissue removed had a statistically significant positive correlation (0.479; P<0.0001). There was no statistically significant difference between the amount of total breast tissue removed and patient response . (p=0.57).
The study supports a positive outcome following breast reduction surgery. Over 95% of the patients surveyed were satisfied, and would do it again. It demonstrates the improvement of the patient’s quality of life regardless of the amount of breast tissue removed. Furthermore, it suggest that the size and weight of the patient has no impact on this outcome. As we face new government and insurance restrictions for surgeries that have both cosmetic and reconstructive value, patient reported outcome studies may have an influence on future third party payer commitments to authorizing surgery on this group of patients. Therefore, the need for prospective validation of our finding is important.
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