Understanding the Recovery Phase of Breast Reduction: Patient Reported Outcomes Correlated with Reduction Weight and BMI
Jeffrey Arendash, New York1, Carrie Stern, MD2, Teresa Benacquista, MD2, Oren Tepper, MD2, Evan Garfein, MD2, Lawrence Draper, MD2, Katie Weichman, MD2.
1Albert Einstein College of Medicine, Bronx, NY, USA, 2Montefiore Medical Center, Bronx, NY, USA.
Introduction: Patients undergoing breast reduction mammoplasty have been shown to have increased patient reported outcomes and quality of life. However, there is a paucity of data looking at the impact of breast reduction mass and body mass index on improvement of pain symptoms as well as quality of life determinants. This information is important for both patient and physician understanding for shared decision-making as well as continued insurance approval. Based on these factors, we sought to describe the recovery phase of breast reconstruction based on weight of resection and the patients' body mass index. We hypothesize that regardless of resection weight, patients will have improved quality of life and decreased back pain.
Methods: After obtaining IRB approval, patients presenting for breast reduction mammoplasty at Montefiore Medical Center between June 2016 and January 2017 were prospectively enrolled. Patients completed Numerical Pain Rating Scale (NPRS), McGill short form pain Questionnaire, and the BREAST-Q (using satisfaction with breast, psychosocial well-being, physical well-being, and sexual well-being) preoperatively, one -week postoperatively, 1-month postoperatively, 3-months postoperatively, and 6-months postoperatively. Patients were divided into three cohorts based on breast reduction specimen weight: small: <500g, intermediate: 500-1000g, and large: >1000g and then analyzed based on demographic factors and complications.
Results: A total of 114 women who were enrolled in the study had completed 6-month follow up and therefore were included for analysis (n=30 (26.3%) in small reduction, n=56 (49.2%) in intermediate reduction, n=28 (24.6%) in large reduction). Patients in each cohort had similar ages, however, body mass index increased corollary to reduction weight (27.9 kg/m2, 31.6 kg/m2, and 35.5 kg/m2 respectively p <0.001). Overall, patients had increased satisfaction with breasts, psychosocial well-being, sexual well-being, physical well-being, and decreased pain level at each postoperative time point (P<0.05). Additionally, when comparing patient's undergoing small, intermediate, and large reductions all had groups displayed decreased pain, and increased satisfaction with breasts, psychosocial well-being sexual well-being, and physical well being at all postoperative time points. There were no significant differences between the level of satisfaction or level of back pain in any category between the groups at each visit (P>0.05).
Patients undergoing breast reduction mammoplasty display decreased pain and improved patient reported outcomes and quality of life regardless of resection weight. Patients display significant improvements as early as one week postoperatively and these improvements are maintained at six months.
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