A Systematic Review of the Impact of Patient Factors on BREAST-Q Outcomes After Reduction Mammoplasty

Abstract

Background As reduction mammoplasty rises in popularity, it will become increasingly important to understand the patient-reported outcome measurements associated with a successful operation. There has been a growing body of literature on BREAST-Q outcomes for patients undergoing reduction mammoplasty, but meta-analyses of patient factors and BREAST-Q Reduction Module scores are lacking. This study sought to ascertain which patient factors were associated with improvements in BREAST-Q scores compared with preoperative levels. Methods A literature review through August 6, 2021, was conducted using the PubMed database to select publications using the BREAST-Q questionnaire to evaluate outcomes after reduction mammoplasty. Studies examining breast reconstruction, breast augmentation, oncoplastic reduction, or breast cancer patients were excluded. BREAST-Q data were stratified by comorbidities, age, body mass index (BMI), complication rate, and resection weight. Results Among 14 articles and 1816 patients, the mean age ranged from 15.8 to 55 years, mean BMI ranged from 22.5 to 32.4 kg/m2, and bilateral mean resected weight ranged from 323 to 1845.96 g. Overall complication rate was 19.9%. On average, satisfaction with breasts improved by 52.1 ± 0.9 points (P < 0.0001), psychosocial well-being improved by 43.0 ± 1.0 points (P < 0.0001), sexual well-being improved by 38.2 ± 1.2 points (P < 0.0001), and physical well-being improved by 27.9 ± 0.8 points (P < 0.0001). The mean age was positively correlated with preoperative sexual well-being (Spearman rank correlation coefficient [SRCC]: 0.61, P < 0.05). Body mass index was negatively correlated with preoperative physical well-being (SRCC: −0.78, P < 0.01) and positively correlated with postoperative satisfaction with breasts (SRCC: 0.53, P < 0.05). The mean bilateral resected weight was significantly positively correlated with postoperative satisfaction with breasts (SRCC: 0.61, P < 0.05). No significant correlations were observed between complication rate and preoperative, postoperative, or mean change in BREAST-Q scores. Conclusions Reduction mammoplasty improves patient satisfaction and quality of life as reflected by the BREAST-Q. Although preoperative or postoperative BREAST-Q scores may be individually influenced by age and BMI, these variables demonstrated no statistically significant effect on the average change between these scores. This literature review suggests that reduction mammoplasty delivers high satisfaction across a diverse range of patient populations, and additional prospective cohort or comparative studies gathering robust data on other patient factors would benefit this area of research.

Reduction mammoplasty, self-esteem, and sexual desire: A pre-post intervention study

“…Only self-esteem was associated with age and surgical procedure, with older women and those who underwent the procedure without implants exhibiting lower levels of self-esteem. This contrasts with the review conducted by Liao et al (2023) , which observed that older age correlated with higher scores of sexual well-being before the intervention, suggesting that older patients generally have greater self-confidence. While our results did indicate that the older age group had higher scores in sexual well-being and two factors of sexual desire, the differences were not statistically significant compared to the younger age group.…”

“…Moreover, post-intervention, no relationship was observed between age groups and self-esteem, nor was there any association between self-esteem and the surgical procedure. This, however, aligns with Liao et al (2023) , which suggested that the positive impact of breast reduction surgery is evident across all BREAST-Q domains regardless of age.…”

“…Regarding the correlational analysis, it is notable that our study did not identify any significant correlation between age and the variables under scrutiny. This finding, as suggested by Liao et al (2023) , implies that breast reduction surgery may yield favourable outcomes across diverse age demographics. Nonetheless, it is imperative to exercise caution in interpreting these results, considering the limitations stemming from the modest sample size and the selective manner in which participants were recruited.…”