Interpreting the BREAST-Q for breast-conserving therapy: Minimal important differences and clinical reference values Journal Article


Authors: Chu, J. J.; Tadros, A. B.; Gallo, L.; Mehrara, B. J.; Morrow, M.; Pusic, A. L.; Voineskos, S. H.; Nelson, J. A.
Article Title: Interpreting the BREAST-Q for breast-conserving therapy: Minimal important differences and clinical reference values
Abstract: Background: The BREAST-Q is an important tool for evaluating patient satisfaction and quality of life in breast-conserving therapy (BCT) patients, but its clinical utility is limited by the lack of guidance on score interpretation. This study determines reference values and the minimal important difference (MID) for the BREAST-Q BCT module. Methods: A retrospective review of BCT patients at Memorial Sloan Kettering Cancer Center from January 2011 to December 2021 was performed. Descriptive statistics were used to summarize median BREAST-Q scores. Distribution-based analyses estimated MIDs based on 0.2 standard deviation of baseline BREAST-Q scores and 0.2 standardized response mean of the difference between baseline and 1-year postoperative BREAST-Q scores. MIDs for different clinical groupings based on body mass index, radiation, and reexcision also were estimated. Results: Overall, 8060 patients were included for determining reference values, and 5673 patients were included for estimating MIDs. Median BREAST-Q scores trended upwards and stabilized by 2 years after surgery for all domains except Physical Well-Being of the Chest, which decreased and stabilized by 2 years. A score interpretation tool, the Real-Time Engagement and Communication Tool, was created based on 25th percentile, median, and 75th percentile scores trajectories. All MID estimates ranged from 3 to 5 points; 4 points was determined to be appropriate for use in clinical practice and research. Conclusions: Reference values and MIDs are crucial to BREAST-Q score interpretation, which can lead to improved clinical evaluation and decision making and improved research methodology. Future research should validate this study’s findings in different patient cohorts. © 2023, Society of Surgical Oncology.
Journal Title: Annals of Surgical Oncology
Volume: 30
Issue: 7
ISSN: 1068-9265
Publisher: Springer  
Date Published: 2023-07-01
Start Page: 4075
End Page: 4084
Language: English
DOI: 10.1245/s10434-023-13222-y
PUBMED: 36840864
PROVIDER: scopus
PMCID: PMC10996067
DOI/URL:
Notes: The MSK Cancer Center Support Grant (P30 CA008748) is acknowledged in the PDF -- Corresponding author is MSK author: Jonas A. Nelson -- Source: Scopus
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MSK Authors
  1. Monica Morrow
    772 Morrow
  2. Babak Mehrara
    448 Mehrara
  3. Jonas Allan Nelson
    209 Nelson
  4. Audree Blythe Tadros
    116 Tadros
  5. Jacqueline J. Chu
    27 Chu