The Northeastern Society of Plastic Surgeons

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Kevin M. Klifto, PharmD, Lauren Luther, Rachael Payne, MD, Charalampos Siotos, MD, Ricardo Bello, MD, MPH, Carisa M. Cooney, MPH, Gedge D. Rosson, MD, Modupe A. McCracken, MD, Michele A. Manahan, MD.
The Johns Hopkins University, Baltimore, MD, USA.

BACKGROUND: Patient satisfaction with breasts is an important metric for evaluating outcomes in breast surgery. The BREAST-Q has been used extensively to assess outcomes in patients undergoing cosmetic and reconstructive breast surgery; however, breast satisfaction in a general population of women is relatively unknown. The Army of Women (AOW) members did not reflect our institutions community. Therefore, the aim of our study is to assess breast satisfaction in female patients without breast cancer and without breast surgery, more representative of the general population.
METHODS: We administered the pre-operative BREAST-Q reconstruction module and RAND-36 to 35 women during gynecology appointments at our institution with a goal of 300 by October 2018. Patients were termed “study population” if they had no history of breast cancer or breast surgery. Data was compared to 300 institutional autologous breast reconstruction patients, and 1201 AOW members. A two-sample paired t-test with 95% CI was used to compare the study population with breast reconstruction patients. The study population and AOW members will be analyzed once our population is at goal, due to the large sample size difference. AOW patients are included for preliminary comparison. Demographic information including age, body mass index, bra size, race/ethnicity, marital and occupation status, education and income level, and past medical history were obtained. Breast satisfaction and physical, sexual, and psychosocial well-being were compared to patients undergoing breast reconstruction at our institution.
RESULTS: Preliminary comparisons of mean BREAST-Q scores were analyzed with our study population and breast reconstruction patients reflected in Table 1. Sexual well-being scores were similar across both groups (57±26, 55±22;p=0.4578) respectively. Study population women were the youngest (44±18, 50±9;p=0.0384). There were no significant differences between BMI (29±8, 27±6;p=0.1896), breast satisfaction (60±25, 55±26;p=0.1395), psychosocial well-being (70±22, 71±20;p=0.1997), sexual well-being (57±26, 55±22;p=0.4578), and physical well-being of the abdomen (82±23, 88±14;p=1.000), when compared to breast reconstruction patients. Physical well-being of the chest was higher in the study population compared to breast reconstruction patients (88±12, 79±16;p=0.0443).
CONCLUSIONS: Normative BREAST-Q is a valuable reference. Breast reconstruction patients have decreased physical well-being of the chest. Normative BREAST-Q scores in our community are comparable to national data. Determining levels of breast satisfaction in a general population of women could serve as an important benchmark for all breast surgical outcomes research involving the BREAST-Q.

Table 1 Mean Scores and Standard Deviations Comparing Three Groups
Study PopulationBreast ReconstructionArmy of WomenP-value+
Satisfaction with Breasts60(±25)55(±26)58(±18)0.1395
Psychosocial Well-being70(±22)71(±20)71(±18)0.1997
Sexual Well-being57(±26)55(±22)56(±18)0.4578
Physical Well-being: Chest88(±12)79(±16)93(±11)0.0443*
Physical Well-being: Abdomen82(±23)88(±14)78(±20)1.0000
+Comparison of study population to breast reconstruction

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