Prospective Evaluation of Health After Breast Reduction Surgery Using the Breast-Q, Short-Form 36, Breast-Related Symptoms Questionnaire, and Modified Breast Evaluation Questionnaire

Abstract

Introduction Breast hypertrophy is a condition associated with physical, psychological, and psychosocial problems. The primary aims of this study were to determine the impact of breast hypertrophy and the effects of breast reduction, performed on the basis of well-described inclusion criteria, on general and breast-related health, using both general and diagnosis-specific validated questionnaires. We used a prospective, longitudinal paired study design. A secondary aim was to analyze the relationship between preoperative breast volume, body mass index, sternal notch-to-nipple distance and the weight of resected tissue on the one hand and improvements in health on the other. Methods Three hundred forty-eight consecutive patients undergoing breast reduction were included and the Short-Form 36 (SF-36), Breast-Related Symptoms Questionnaire (BRSQ), Modified Breast Evaluation Questionnaire (mBEQ) and BREAST-Q were distributed preoperatively and 1 year postoperatively. Results A total of 284 (83%) patients answered the questionnaires either preoperatively or postoperatively, or both, and 159 (46%) patients answered both. The breast hypertrophy patients had significantly lower scores preoperatively than the matched normal population when it came to all dimensions of the SF-36 and mBEQ. The preoperative scores for both the BRSQ and BREAST-Q were low. After breast reduction, there were significant improvements in all dimensions of the BRSQ, mBEQ, and Breast-Q and in several dimensions of the SF-36. Conclusions Breast reduction reduces or removes disease-associated pain. It improves or normalizes perceived health and psychosocial self-esteem in slightly obese women or women of normal weight with preoperative breast volumes around 1000 mL. Women with higher preoperative breast volumes and longer sternal notch-to-nipple distances appear to be more satisfied with the cosmetic result postoperatively.

Inferior pedicle with inverted-T procedure for bilateral reduction mammoplasty provided satisfactory surgical and aesthetic outcome

“…Aesthetic outcome using ABNSW score that ranges between zero and 15, was evaluated by a median score of 11 and 10 with a total median score of 10 and nonsignificant differences between items' scores as determined by both judge surgeons with non-significant difference regarding the total score (Table 4). [14][15][16][17] and was significantly (p<0.0001) higher in comparison to median value of the preoperative score that was 12 (IQR: [11][12][13][14]. Preoperative BRASS score was negatively correlated, while was positively correlated with education level, and the correlation was significant with age and BMI, but was nonsignificant with education level.…”

“…These findings indicated the positive feedback effect of RM on patients' psychological status and go in hand with Lewin et al who reported that RM alleviates or minimizes macromastia-associated pain, improves or normalizes health and psychosocial self-esteem especially in women with high preoperative breast volumes and long SN-N distances who documented more satisfaction with the PO cosmetic result than women slightly obese or had average weight with breast volume about 1000 ml. 16 Moreover, Krucoff et al and Nuzzi et al found RM patients especially young women experience excellent breast-related QoL with high satisfaction with breasts and sexual wellbeing. 17,18 Crittenden et al reported statistically significant improvements in satisfaction with breasts, psychosocial well-being, sexual well-being and physical well-being scorings of patients with breast hypertrophy after RM in comparison to preoperative scores.…”

Does large breast problem and macromastıa surgery affect a woman's body image, depressıon level, sexual lıfe, and qualıty of lıfe? A prospectıve study

“…In contrast, body perception affects women both psychosocially and psychosexually 7 . Recent studies stated that women with breast hypertrophy problem have lower self-respect 4,5,10 . Janik et al 3 reported that body image dissatisfaction was a great problem for women with breast hypertrophy and shame, depression, and anxiety were associated with weak body image.…”

“…On the other hand, it has been reported that breast hypertrophy is an important factor affecting the body perception and is associated with negative body image 4,[7][8][9][10][11] . In addition, it has been stated that the increase in breast size in women is associated with depression level 5 .…”

A systematic review and meta-analysis of risks and benefits with breast reduction in the public healthcare system: priorities for further research

“…Most of the symptoms described impair health-related quality of life (HRQoL). A breast reduction (reduction mammaplasty) is considered effective at reducing physical and psychosocial symptoms and improving HRQoL [ 12 , 13 ]; however, similar effects are also achieved when a breast reduction is performed for cosmetic reasons and therefore it is difficult to distinguish which patients should be operated in the publicly funded healthcare system [ 14 , 15 ]. Moreover, there is no standardisation regarding the assessment and prioritising of functional problems, such as back pain, compared to non-functional problems, for example suffering due to appearance [ 16 ].…”