Skip to main content

Advertisement

SpringerLink
Log in

BREAST-Q REACT: Qualitative Assessment of the Design, Functionality, and Clinical Utility of a New Score Interpretation Tool

  • Breast Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

The BREAST-Q real-time engagement and communication tool (REACT) was developed to aid with BREAST-Q score interpretation and guide patient-centered care.

Objective

The purpose of this qualitative study was to examine the perspectives of patients and providers on the design, functionality, and clinical utility of REACT and refine the REACT based on their recommendations.

Methods

We conducted three patient focus groups with women who were at least 6 postoperative months from their postmastectomy breast reconstruction, and two provider focus groups with plastic surgeons, breast surgeons, and advanced practice providers. Focus groups were audio-taped, transcribed verbatim, and analyzed thematically.

Results

A total of 18 breast reconstruction patients and 14 providers participated in the focus groups. Themes identified by thematic analysis were organized into two categories: (1) design and functionality, and (2) clinical utility. On the design and functionality of REACT, four major themes were identified: visual appeal and usefulness; contextualizing results; ability to normalize patients’ experiences, noting participants’ concerns; and suggested modifications. On the clinical utility of REACT, three major themes were identified: potential to empower patients to communicate with their providers; increase patient and provider motivation to engage with the BREAST-Q; and effective integration into clinical workflow.

Conclusion

Patients and providers in this qualitative study indicated that with some modifications, REACT has a great potential to elevate the clinical utility of the BREAST-Q by enhancing patient–provider communication that can lead to patient-centered, clinically relevant action recommendations based on longitudinal BREAST-Q scores.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Pusic AL, Klassen AF, Scott AM, Klok JA, Cordeiro PG, Cano SJ. Development of a new patient-reported outcome measure for breast surgery: the BREAST-Q. Plast Reconstr Surg. 2009;124(2):345–53. https://doi.org/10.1097/PRS.0b013e3181aee807.

    Article  CAS  PubMed  Google Scholar 

  2. Pusic AL, Lemaine V, Klassen AF, Scott AM, Cano SJ. Patient-reported outcome measures in plastic surgery: use and interpretation in evidence-based medicine. Plast Reconstr Surg. 2011;127(3):1361–7. https://doi.org/10.1097/PRS.0b013e3182063276.

    Article  CAS  PubMed  Google Scholar 

  3. Cano SJ, Klassen AF, Scott AM, Cordeiro PG, Pusic AL. The BREAST-Q: further validation in independent clinical samples. Plast Reconstr Surg. 2012;129(2):293–302. https://doi.org/10.1097/PRS.0b013e31823aec6b.

    Article  CAS  PubMed  Google Scholar 

  4. Dean NR, Crittenden T. A five year experience of measuring clinical effectiveness in a breast reconstruction service using the BREAST-Q patient reported outcomes measure: a cohort study. J Plast Reconstr Aesthet Surg. 2016;69(11):1469–77. https://doi.org/10.1016/j.bjps.2016.08.015.

    Article  PubMed  Google Scholar 

  5. Cohen WA, Mundy LR, Ballard TN, Klassen A, Cano SJ, Browne J, Pusic AL. The BREAST-Q in surgical research: a review of the literature 2009–2015. J Plast Reconstr Aesthet Surg. 2016;69(2):149–62. https://doi.org/10.1016/j.bjps.2015.11.013.

    Article  PubMed  Google Scholar 

  6. Fuzesi S, Cano SJ, Klassen AF, Atisha D, Pusic AL. Validation of the electronic version of the BREAST-Q in the army of women study. Breast. 2017;33:44–9. https://doi.org/10.1016/j.breast.2017.02.015.

    Article  PubMed  Google Scholar 

  7. Ong WL, Schouwenburg MG, van Bommel ACM, et al. A standard set of value-based patient-centered outcomes for breast cancer: the International Consortium for Health Outcomes Measurement (ICHOM) initiative. JAMA Oncol. 2017;3(5):677–85. https://doi.org/10.1001/jamaoncol.2016.4851.

    Article  PubMed  Google Scholar 

  8. Pusic AL, Matros E, Fine N, et al. Patient-reported outcomes 1 year after immediate breast reconstruction: results of the Mastectomy Reconstruction Outcomes Consortium study. J Clin Oncol. 2017;35(22):2499–506. https://doi.org/10.1200/jco.2016.69.9561.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Santosa KB, Qi J, Kim HM, Hamill JB, Wilkins EG, Pusic AL. Long-term patient-reported outcomes in postmastectomy breast reconstruction. JAMA Surg. 2018;153(10):891–9. https://doi.org/10.1001/jamasurg.2018.1677.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Liu LQ, Branford OA, Mehigan S. BREAST-Q measurement of the patient perspective in oncoplastic breast surgery: a systematic review. Plast Reconstr Surg Glob Open. 2018;6(8):e1904. https://doi.org/10.1097/gox.0000000000001904.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Allen RJ Jr, Sobti N, Patel AR, et al. Laterality and patient-reported outcomes following autologous breast reconstruction with free abdominal tissue: an 8-year examination of BREAST-Q data. Plast Reconstr Surg. 2020;146(5):964–75. https://doi.org/10.1097/prs.0000000000007239.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Voineskos SH, Klassen AF, Cano SJ, Pusic AL, Gibbons CJ. Giving meaning to differences in BREAST-Q scores: minimal important difference for breast reconstruction patients. Plast Reconstr Surg. 2020;145(1):11e–20e. https://doi.org/10.1097/prs.0000000000006317.

    Article  CAS  PubMed  Google Scholar 

  13. U.S. Food & Drug Administration. MDDT summary of evidence and basis of qualification decision for BREAST-Q reconstruction module. 2020. Available at: https://www.fda.gov/media/141349/download. Accessed 1 Jan 2023.

  14. Seth I, Seth N, Bulloch G, Rozen WM, Hunter-Smith DJ. Systematic review of Breast-Q: a tool to evaluate post-mastectomy breast reconstruction. Breast Cancer (Dove Med Press). 2021;13:711–24. https://doi.org/10.2147/bctt.S256393.

    Article  PubMed  Google Scholar 

  15. Arora N, Patel R, Sohi G, Merchant S, Martou G. A scoping review of the application of BREAST-Q in surgical research. JPRAS Open. 2023;37:9–23. https://doi.org/10.1016/j.jpra.2023.04.005.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Nelson JA, Chu JJ, Dabic S, et al. Moving towards patient-reported outcomes in routine clinical practice: implementation lessons from the BREAST-Q. Qual Life Res. 2023;32(1):115–25. https://doi.org/10.1007/s11136-022-03213-z.

    Article  PubMed  Google Scholar 

  17. Basch E, Abernethy AP. Supporting clinical practice decisions with real-time patient-reported outcomes. J Clin Oncol. 2011;29(8):954–6. https://doi.org/10.1200/JCO.2010.33.2668.

    Article  PubMed  Google Scholar 

  18. Basch E, Deal AM, Kris MG, et al. Symptom monitoring with patient-reported outcomes during routine cancer treatment: a randomized controlled trial. J Clin Oncol. 2016;34(6):557–65. https://doi.org/10.1200/JCO.2015.63.0830.

    Article  CAS  PubMed  Google Scholar 

  19. van Egdom LSE, Oemrawsingh A, Verweij LM, et al. Implementing patient-reported outcome measures in clinical breast cancer care: a systematic review. Value Health. 2019;22(10):1197–226. https://doi.org/10.1016/j.jval.2019.04.1927.

    Article  PubMed  Google Scholar 

  20. Graupner C, Kimman ML, Mul S, et al. Patient outcomes, patient experiences and process indicators associated with the routine use of patient-reported outcome measures (PROMs) in cancer care: a systematic review. Support Care Cancer. 2021;29(2):573–93. https://doi.org/10.1007/s00520-020-05695-4.

    Article  PubMed  Google Scholar 

  21. Lu SC, Porter I, Valderas JM, Harrison CJ, Sidey-Gibbons C. Effectiveness of routine provision of feedback from patient-reported outcome measurements for cancer care improvement: a systematic review and meta-analysis. J Patient Rep Outcomes. 2023;7(1):54. https://doi.org/10.1186/s41687-023-00578-8.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Luckett T, Butow PN, King MT. Improving patient outcomes through the routine use of patient-reported data in cancer clinics: future directions. Psychooncology. 2009;18(11):1129–38. https://doi.org/10.1002/pon.1545.

    Article  CAS  PubMed  Google Scholar 

  23. Berry DL, Blumenstein BA, Halpenny B, et al. Enhancing patient-provider communication with the electronic self-report assessment for cancer: a randomized trial. J Clin Oncol. 2011;29(8):1029–35. https://doi.org/10.1200/jco.2010.30.3909.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Jensen RE, Snyder CF, Abernethy AP, et al. Review of electronic patient-reported outcomes systems used in cancer clinical care. J Oncol Pract. 2014;10(4):e215–22. https://doi.org/10.1200/jop.2013.001067.

    Article  PubMed  Google Scholar 

  25. Kotronoulas G, Kearney N, Maguire R, Harrow A, Di Domenico D, Croy S, MacGillivray S. What is the value of the routine use of patient-reported outcome measures toward improvement of patient outcomes, processes of care, and health service outcomes in cancer care? A systematic review of controlled trials. J Clin Oncol. 2014;32(14):1480–501. https://doi.org/10.1200/jco.2013.53.5948.

    Article  PubMed  Google Scholar 

  26. Howell D, Molloy S, Wilkinson K, Green E, Orchard K, Wang K, Liberty J. Patient-reported outcomes in routine cancer clinical practice: a scoping review of use, impact on health outcomes, and implementation factors. Ann Oncol. 2015;26(9):1846–58. https://doi.org/10.1093/annonc/mdv181.

    Article  CAS  PubMed  Google Scholar 

  27. Trautmann F, Hentschel L, Hornemann B, et al. Electronic real-time assessment of patient-reported outcomes in routine care-first findings and experiences from the implementation in a comprehensive cancer center. Support Care Cancer. 2016;24(7):3047–56. https://doi.org/10.1007/s00520-016-3127-0.

    Article  PubMed  Google Scholar 

  28. LeBlanc TW, Abernethy AP. Patient-reported outcomes in cancer care—hearing the patient voice at greater volume. Nat Rev Clin Oncol. 2017;14(12):763–72. https://doi.org/10.1038/nrclinonc.2017.153.

    Article  PubMed  Google Scholar 

  29. Yang LY, Manhas DS, Howard AF, Olson RA. Patient-reported outcome use in oncology: a systematic review of the impact on patient-clinician communication. Support Care Cancer. 2018;26(1):41–60. https://doi.org/10.1007/s00520-017-3865-7.

    Article  CAS  PubMed  Google Scholar 

  30. Chan EKH, Edwards TC, Haywood K, Mikles SP, Newton L. Implementing patient-reported outcome measures in clinical practice: a companion guide to the ISOQOL user’s guide. Qual Life Res. 2019;28(3):621–7. https://doi.org/10.1007/s11136-018-2048-4.

    Article  PubMed  Google Scholar 

  31. Cusatis R, Holt JM, Williams J, et al. The impact of patient-generated contextual data on communication in clinical practice: a qualitative assessment of patient and clinician perspectives. Patient Educ Couns. 2020;103(4):734–40. https://doi.org/10.1016/j.pec.2019.10.020.

    Article  PubMed  Google Scholar 

  32. Cheung YT, Chan A, Charalambous A, et al. The use of patient-reported outcomes in routine cancer care: preliminary insights from a multinational scoping survey of oncology practitioners. Support Care Cancer. 2022;30(2):1427–39. https://doi.org/10.1007/s00520-021-06545-7.

    Article  PubMed  Google Scholar 

  33. Payne A, Horne A, Bayman N, et al. Patient and clinician-reported experiences of using electronic patient reported outcome measures (ePROMs) as part of routine cancer care. J Patient Rep Outcomes. 2023;7(1):42. https://doi.org/10.1186/s41687-023-00544-4.

    Article  PubMed  PubMed Central  Google Scholar 

  34. Bennett AV, Jensen RE, Basch E. Electronic patient-reported outcome systems in oncology clinical practice. CA Cancer J Clin. 2012;62(5):337–47. https://doi.org/10.3322/caac.21150.

    Article  PubMed  Google Scholar 

  35. Lehmann J, Rothmund M, Riedl D, Rumpold G, Grote V, Fischer MJ, Holzner B. Clinical outcome assessment in cancer rehabilitation and the central role of patient-reported outcomes. Cancers (Basel). 2021;14(1):84. https://doi.org/10.3390/cancers14010084.

    Article  PubMed  Google Scholar 

  36. Nelson JA, Chu JJ, McCarthy CM, Stern CS, Shamsunder MG, Pusic AL, Mehrara BJ. BREAST-Q REACT: clinical reference values for the BREAST-Q in post-mastectomy breast reconstruction patients. Ann Surg Oncol. 2022;29(8):5280–93. https://doi.org/10.1245/s10434-022-11521-4.

    Article  PubMed  PubMed Central  Google Scholar 

  37. Chu JJ, Tadros AB, Gallo L, et al. Interpreting the BREAST-Q for breast-conserving therapy: minimal important differences and clinical reference values. Ann Surg Oncol. 2023;30(7):4075–84. https://doi.org/10.1245/s10434-023-13222-y.

    Article  PubMed  Google Scholar 

  38. Kreuger RMC. Focus groups: a practical guide to applied research. 5th edn. London: Sage Publications; 2014.

    Google Scholar 

  39. Vaismoradi M, Snelgrove S. Theme in qualitative content analysis and thematic analysis. Forum Qual Sozialforschung/Forum Qual Soc Res. 2019. https://doi.org/10.17169/fqs-20.3.3376.

    Article  Google Scholar 

  40. Vaismoradi M, Turunen H, Bondas T. Content analysis and thematic analysis: Implications for conducting a qualitative descriptive study. Nurs Health Sci. 2013;15(3):398–405. https://doi.org/10.1111/nhs.12048.

    Article  PubMed  Google Scholar 

  41. Brundage MD, Smith KC, Little EA, Bantug ET, Snyder CF, The PRO Data Presentation Stakeholder Advisory Board. Communicating patient-reported outcome scores using graphic formats: results from a mixed-methods evaluation. Qual Life Res. 2015;24(10):2457–72. https://doi.org/10.1007/s11136-015-0974-y.

    Article  PubMed  PubMed Central  Google Scholar 

  42. Snyder C, Smith K, Holzner B, Rivera YM, Bantug E, Brundage M. Making a picture worth a thousand numbers: recommendations for graphically displaying patient-reported outcomes data. Qual Life Res. 2019;28(2):345–56. https://doi.org/10.1007/s11136-018-2020-3.

    Article  PubMed  Google Scholar 

  43. Sandhu S, King Z, Wong M, et al. Implementation of electronic patient-reported outcomes in routine cancer care at an academic center: identifying opportunities and challenges. JCO Oncol Pract. 2020;16(11):e1255–63. https://doi.org/10.1200/op.20.00357.

    Article  PubMed  Google Scholar 

  44. Laitio AM, Giunti G, Halonen R. Perceived barriers and facilitators in using patient-reported outcome systems for cancer care: systematic mapping study. JMIR Cancer. 2023;9:e40875. https://doi.org/10.2196/40875.

    Article  PubMed  PubMed Central  Google Scholar 

  45. Schover LR, Yuan Y, Fellman BM, Odensky E, Lewis PE, Martinetti P. Efficacy trial of an Internet-based intervention for cancer-related female sexual dysfunction. J Natl Compr Canc Netw. 2013;11(11):1389–97. https://doi.org/10.6004/jnccn.2013.0162.

    Article  PubMed  PubMed Central  Google Scholar 

  46. Badr H, Krebs P. A systematic review and meta-analysis of psychosocial interventions for couples coping with cancer. Psychooncology. 2013;22(8):1688–704. https://doi.org/10.1002/pon.3200.

    Article  PubMed  Google Scholar 

  47. Stagl JM, Bouchard LC, Lechner SC, et al. Long-term psychological benefits of cognitive-behavioral stress management for women with breast cancer: 11-year follow-up of a randomized controlled trial. Cancer. 2015;121(11):1873–81. https://doi.org/10.1002/cncr.29076.

    Article  PubMed  Google Scholar 

  48. Cho Y, Do J, Jung S, Kwon O, Jeon JY. Effects of a physical therapy program combined with manual lymphatic drainage on shoulder function, quality of life, lymphedema incidence, and pain in breast cancer patients with axillary web syndrome following axillary dissection. Support Care Cancer. 2016;24(5):2047–57. https://doi.org/10.1007/s00520-015-3005-1.

    Article  PubMed  Google Scholar 

  49. Snyder CF, Blackford AL, Aaronson NK, Detmar SB, Carducci MA, Brundage MD, Wu AW. Can patient-reported outcome measures identify cancer patients’ most bothersome issues? J Clin Oncol. 2011;29(9):1216–20. https://doi.org/10.1200/JCO.2010.33.2080.

    Article  PubMed  Google Scholar 

  50. Oerlemans S, Arts LP, Horevoorts NJ, van de Poll-Franse LV. “Am I normal?” The wishes of patients with lymphoma to compare their patient-reported outcomes with those of their peers. J Med Internet Res. 2017;19(8):e288. https://doi.org/10.2196/jmir.7079.

    Article  PubMed  PubMed Central  Google Scholar 

  51. Philpot LM, Barnes SA, Brown RM, Austin JA, James CS, Stanford RH, Ebbert JO. Barriers and benefits to the use of patient-reported outcome measures in routine clinical care: a qualitative study. Am J Med Qual. 2018;33(4):359–64. https://doi.org/10.1177/1062860617745986.

    Article  PubMed  Google Scholar 

  52. Mundy LR, Homa K, Klassen AF, Pusic AL, Kerrigan CL. Breast cancer and reconstruction: normative data for interpreting the BREAST-Q. Plast Reconstr Surg. 2017;139(5):1046e–55e. https://doi.org/10.1097/prs.0000000000003241.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  53. Klifto KM, Aravind P, Major M, et al. Establishing institution-specific normative data for the BREAST-Q reconstruction module: a prospective study. Aesthet Surg J. 2020;40(6):NP348–55. https://doi.org/10.1093/asj/sjz296.

    Article  PubMed  Google Scholar 

  54. Boyce MB, Browne JP, Greenhalgh J. The experiences of professionals with using information from patient-reported outcome measures to improve the quality of healthcare: a systematic review of qualitative research. BMJ Qual Saf. 2014;23(6):508–18. https://doi.org/10.1136/bmjqs-2013-002524.

    Article  PubMed  Google Scholar 

  55. Graupner C, Breukink SO, Mul S, Claessens D, Slok AHM, Kimman ML. Patient-reported outcome measures in oncology: a qualitative study of the healthcare professional’s perspective. Support Care Cancer. 2021;29(9):5253–61. https://doi.org/10.1007/s00520-021-06052-9.

    Article  PubMed  PubMed Central  Google Scholar 

  56. Nguyen H, Butow P, Dhillon H, Sundaresan P. A review of the barriers to using patient-reported outcomes (PROs) and patient-reported outcome measures (PROMs) in routine cancer care. J Med Radiat Sci. 2021;68(2):186–95. https://doi.org/10.1002/jmrs.421.

    Article  PubMed  Google Scholar 

  57. Takeuchi EE, Keding A, Awad N, et al. Impact of patient-reported outcomes in oncology: a longitudinal analysis of patient-physician communication. J Clin Oncol. 2011;29(21):2910–7. https://doi.org/10.1200/jco.2010.32.2453.

    Article  PubMed  Google Scholar 

  58. Greenhalgh J, Abhyankar P, McCluskey S, Takeuchi E, Velikova G. How do doctors refer to patient-reported outcome measures (PROMS) in oncology consultations? Qual Life Res. 2013;22(5):939–50. https://doi.org/10.1007/s11136-012-0218-3.

    Article  PubMed  Google Scholar 

  59. Santana MJ, Haverman L, Absolom K, Takeuchi E, Feeny D, Grootenhuis M, Velikova G. Training clinicians in how to use patient-reported outcome measures in routine clinical practice. Qual Life Res. 2015;24(7):1707–18. https://doi.org/10.1007/s11136-014-0903-5.

    Article  PubMed  Google Scholar 

  60. Anatchkova M, Donelson SM, Skalicky AM, McHorney CA, Jagun D, Whiteley J. Exploring the implementation of patient-reported outcome measures in cancer care: need for more real-world evidence results in the peer reviewed literature. J Patient Rep Outcomes. 2018;2(1):64. https://doi.org/10.1186/s41687-018-0091-0.

    Article  PubMed  PubMed Central  Google Scholar 

  61. Howell D, Mayer DK, Fielding R, et al. Management of cancer and health after the clinic visit: a call to action for self-management in cancer care. J Natl Cancer Inst. 2021;113(5):523–31. https://doi.org/10.1093/jnci/djaa083.

    Article  PubMed  Google Scholar 

  62. Howell D, Harth T, Brown J, Bennett C, Boyko S. Self-management education interventions for patients with cancer: a systematic review. Support Care Cancer. 2017;25(4):1323–55. https://doi.org/10.1007/s00520-016-3500-z.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

This work was supported by a Plastic Surgery Foundation Pilot Research Grant.

Funding

This research was funded in part by a Plastic Surgery Foundation Pilot Research Grant (to JAN) and by NIH/NCI Cancer Center Support Grant P30 CA008748.

Author information

Authors and Affiliations

  1. Division of Plastic and Reconstructive Surgery Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Minji Kim BS, Mei-fan Parnes MS, Cayla Bruce PA-C, Carrie S. Stern MD, Robert J. Allen Jr. MD & Jonas A. Nelson MD, MPH

  2. Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Jaime L. Gilliland MA

  3. Division of Plastic and Reconstructive Surgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA

    Andrea L. Pusic MD, MHS

  4. Breast Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Audree B. Tadros MD, MPH

Authors
  1. Minji Kim BS
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jaime L. Gilliland MA
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Mei-fan Parnes MS
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Cayla Bruce PA-C
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Carrie S. Stern MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Robert J. Allen Jr. MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Andrea L. Pusic MD, MHS
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Audree B. Tadros MD, MPH
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Jonas A. Nelson MD, MPH
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jonas A. Nelson MD, MPH.

Ethics declarations

Disclosure

Jonas A. Nelson has served as a consultant for RTI. The BREAST-Q is jointly owned by the Memorial Sloan Kettering Cancer Center and the University of British Columbia. Carrie S. Stern has equity in MirrorMe3D. Andrea L. Pusic is a co-developer of the BREAST-Q and as such receives a share of any license revenues when the BREAST-Q is used in industry-sponsored clinical trials. The BREAST-Q is provided free of charge for academic research and use in clinical practice by health care providers with individual patients. Minji Kim, Jaime L. Gilliland, Mei-fan Parnes, Cayla Bruce, Robert J. Allen Jr, and Audree B. Tadros declare no conflicts of interest.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

Below is the link to the electronic supplementary material.

Supplementary file1 (DOCX 18 KB)

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Kim, M., Gilliland, J.L., Parnes, Mf. et al. BREAST-Q REACT: Qualitative Assessment of the Design, Functionality, and Clinical Utility of a New Score Interpretation Tool. Ann Surg Oncol (2024). https://doi.org/10.1245/s10434-024-15185-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1245/s10434-024-15185-0

Keywords

Search

Navigation