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Greek translation and cultural adaptation of new scales and checklists for the BREAST-Q Reconstruction Module

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The impact of post-mastectomy breast reconstructive surgery on the health-related quality of life (HRQoL) of breast cancer patients has gained research and clinical interest in the last decades. Using valid and reliable patient-reported outcome measures (PROMs) to assess HRQoL from the patients’ perspective provides critical information to better-inform care delivery. The BREAST-Q is a PROM used worldwide to evaluate outcomes of breast surgery. This study describes the translation and cultural adaptation process to develop the Greek version of the latissimus dorsi scales and radiation checklist for BREAST-Q Reconstruction Module.


Our team obtained permission to use and translate the Satisfaction with Back and Physical Well-Being: Back and Shoulder scales, and Adverse Effects of Radiation checklist of the BREAST-Q Reconstruction Module. The translation and cultural adaptation were conducted according to the International Society of Pharmacoeconomics and Outcomes Research guidelines. Two forward translations and one back translation were prepared, followed by cognitive debriefing interviews with patients.


Forward translation revealed no items that were difficult to translate. Back translation resulted in the re-translation of one item that was found to have a different meaning than the original English version. Nine patients participated in the cognitive debriefing interviews and confirmed that the Greek version of the new scales and checklist were easy to understand.


Translation and cultural adaptation of the latissimus dorsi scales and radiation checklist resulted in the equivalent Greek version, which plastic surgeons can use in Greece to measure satisfaction and quality of life outcomes from the patient’s perspective.

Level of evidence: Not ratable.

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Correspondence to Efterpi Demiri.

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Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The study was approved by the Research Ethics Board of the Papageorgiou Hospital in Thessaloniki, Greece.

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All patients provided informed written consent before participating in the cognitive debriefing interviews.

Conflict of interest

Efterpi Demiri, Anastasios Pagkalos, Elena Tsangaris, Avra Drougou, Leonidas Pavlidis, Dimitrios Dionyssiou, and Georgios Pagkalos declare that they have no conflict of interest.

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Demiri, E., Pagkalos, A., Tsangaris, E. et al. Greek translation and cultural adaptation of new scales and checklists for the BREAST-Q Reconstruction Module. Eur J Plast Surg 45, 95–99 (2022).

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