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BREAST-Q REACT: Clinical Reference Values for the BREAST-Q in Post-mastectomy Breast Reconstruction Patients

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

Abstract

Background

The BREAST-Q is the most commonly used patient-reported outcome measure (PROM) for breast reconstruction research. However, clinical implementation of this PROM has been impeded by a lack of context for score interpretation. The aim of this study was to define reference values for the BREAST-Q at discrete timepoints following surgery, generating a tool for real-time score interpretation.

Methods

BREAST-Q scores were prospectively obtained in women who underwent implant or autologous post-mastectomy breast reconstruction preoperatively and for 2 years following surgery at Memorial Sloan Kettering Cancer Center (MSK). Descriptive statistics were used to create reference values for BREAST-Q satisfaction and quality-of-life subscales. Reference values were externally validated by comparing patient characteristics and BREAST-Q scores between the MSK and the Mastectomy Reconstruction Outcomes Consortium (MROC) study cohorts.

Results

Overall, 3268 MSK patients and 2814 MROC patients were included for analysis. When MSK and MROC cohorts were compared for validation, there were some statistical differences in BREAST-Q scores; however, most of these differences did not meet the minimal clinically important difference of 4 points. Reference values were used to create the BREAST-Q Real-time Engagement and Communication Tool (REACT).

Conclusions

Using a large cohort of patients, we have defined BREAST-Q reference values for post-mastectomy breast reconstruction patients for use in clinical practice. The BREAST-Q REACT will help breast reconstruction providers gauge patient wellbeing and satisfaction relative to the “average” breast reconstruction patient and determine which patients may benefit from additional intervention.

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Acknowledgments

This research was funded in part through the NIH/NCI Cancer Center Support Grant P30CA008748. Dagmar Schnau provided editorial assistance.

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Authors and Affiliations

Authors

Contributions

JAN, JJC, CMM, CSS, MGS, ALP, and BJM provided (1) substantial contributions to conception and design, acquisition of data, or analysis and interpretation of data; (2) drafting the article or revising it critically for important intellectual content; (3) final approval of the version to be published; and (4) agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. JAN and JJC have verified the underlying data of this study.

Corresponding authors

Correspondence to Jonas A. Nelson MD, MPH or Jacqueline J. Chu BA.

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Disclosure

Andrea Pusic is a codeveloper of the BREAST-Q, which is owned by Memorial Sloan Kettering Cancer Center. She receives a portion of the licensing fees (royalty payments) when the BREAST-Q is used in industry-sponsored clinical trials. Babak Mehrara is a consultant for PureTech Corporation; received Investigator initiated grant from Regeneron. The remaining authors declare no conflicts of interest.

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Jonas A. Nelson and Jacqueline J. Chu are co-first authors.

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Nelson, J.A., Chu, J.J., McCarthy, C.M. et al. BREAST-Q REACT: Clinical Reference Values for the BREAST-Q in Post-mastectomy Breast Reconstruction Patients. Ann Surg Oncol 29, 5280–5293 (2022). https://doi.org/10.1245/s10434-022-11521-4

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  • DOI: https://doi.org/10.1245/s10434-022-11521-4

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