Prospective Analysis of Satisfaction by Means of BREASTQ in 156 Patients Who Underwent Breast Reduction.

Abstract

Sir: Greco and Noone have recently published in Plastic and Reconstructive Surgery a very interesting article entitled “Evidence-Based Medicine: Reduction Mammaplasty.”1 We would like to congratulate the authors for their article and we want to direct attention to the evaluation of the patient’s point of view about reduction mammaplasty. In our recent study,2 we have shown how patients require more attention in presurgical consultations and that clear communication should be prioritized to ensure that the surgeon understands the patient’s expectations; thus, the use of patient-reported outcome instruments could help us to study the correct way to approach the patient’s expectations. The assessment of quality of life before and after surgery cannot be based on personal considerations of the attending physician, but must necessarily be expressed through objective studies, such as evaluation by means of the BREAST-Q.3 The BREAST-Q is considered worldwide the best instrument with which to quantify the patient’s perception before and after breast surgical procedures.4 At our Department of Plastic, Reconstructive and Aesthetic Surgery from September of 2011 to September of 2015, 156 consecutive patients who underwent breast reduction answered both preoperative and postoperative modules of the BREAST-Q. This study was approved by the ethics committee of our hospital, and each subject provided written informed consent before participating in the study. We administered the questionnaire 2 weeks before surgery and almost 6 months after surgery, and we performed a statistical analysis to compare preoperative and postoperative answers. Statistically significant results were observed between the mean scores on all four BREAST-Q scales: satisfaction with appearance of breasts, psychosocial well-being, sexual well-being, and physical well-being. In all of the patients, the raw score considered in this study was greater than or equal to 4 (Table 1). The concept of modern surgery has evolved from strictly a science that deals with a “disease to treat” rather than the “patient to be cured” to a psychosurgery, in which we aim is to provide the patient with the greatest degree of satisfaction in the shortest possible time. This concept is feasible only if the satisfaction of the patient and the improvement of quality of life can be assessed objectively from a scientific point of view.5 The point of view of the patient must be made scientifically valid and must be provable. The use of questionnaires is the only way to analyze scientifically and objectively the perception of the patient’s own body and that he or she would like to correct the defect. We think that the use of the BREAST-Q questionnaire should become part of the routine management of patients who are candidates for mammary and reconstructive surgical procedures and should be discussed and compared according to the needs of the patient.Table 1.: BREAST-Q Preoperative and Postoperative Modules in 156 PatientsDISCLOSURE The authors do not have any commercial associations that might pose or create a conflict of interest with information presented in this communication. No intramural or extramural funding supported any aspect of this work. Annalisa Cogliandro, M.D., Ph.D.Mauro Barone, M.D.Paolo Persichetti, M.D., Ph.D.Plastic and Reconstructive Surgery UnitCampus Bio-Medico University of RomeRome, Italy