Predicting postoperative satisfaction with breasts: How important is the preoperative BREAST-Q score? Journal Article
| Authors: | Kim, M.; Matros, E.; Boe, L. A.; Stern, C. S.; Mehrara, B. J.; Allen, R. J. Jr; Nelson, J. A. |
| Article Title: | Predicting postoperative satisfaction with breasts: How important is the preoperative BREAST-Q score? |
| Abstract: | Background: The role that preoperative Satisfaction with Breast plays in a patient’s postoperative course after postmastectomy breast reconstruction (PMBR) is not understood. The aim of this study is to understand the impact of the preoperative score on postoperative outcome as an independent variable. Methods: We examined patients who underwent PMBR between 2017 and 2021 and who completed the BREAST-Q Satisfaction with Breasts at 1 year postoperatively. Two multiple linear regression models (Model 1 with the preoperative Satisfaction with Breasts score and Model 2 without the preoperative score), likelihood ratio tests, simple t-statistics, and sample patient dataset to predict the 1 year score were performed. Multiple imputation was used to account for missing preoperative scores. Results: Overall, 2324 patients were included. Model 1 showed that the preoperative score is significantly associated with the postoperative score (β = 0.09, 95% confidence interval 0.04–0.14; p < 0.001). Comparing Model 1 and Model 2 demonstrated that including preoperative Satisfaction with Breasts in a regression significantly improves model fit (test statistic = 10.04; p = 0.0021). Using the absolute value of the t-statistics as a measure of variable importance in linear regression, the importance of the preoperative score was quantified as 3.39—more important than neoadjuvant radiation, mastectomy weight, body mass index, bilateral prophylactic mastectomy, and race, but less than adjuvant radiation, reconstruction type, and psychiatric diagnoses. Conclusion: Preoperative Satisfaction with Breasts scores are an important independent predictor of postoperative satisfaction after PMBR. Just as vital sign and work-up are carefully documented before surgery, preoperative scores should be collected to pre-emptively gauge patients’ satisfaction and optimize postoperative outcomes. © Society of Surgical Oncology 2024. |
| Keywords: | adult; aged; middle aged; patient satisfaction; major clinical study; postoperative period; hypertension; cancer radiotherapy; comparative study; neoadjuvant therapy; follow up; follow-up studies; preoperative evaluation; quality of life; mastectomy; psychology; pathology; breast neoplasms; breast reconstruction; mammaplasty; retrospective study; age; postoperative complication; questionnaire; body mass; preoperative period; adjuvant chemotherapy; breast tumor; diabetes mellitus; surgery; satisfaction; neoadjuvant chemotherapy; adjuvant radiotherapy; race difference; nipple-sparing mastectomy; skin-sparing mastectomy; caucasian; vital sign; psychiatric diagnosis; prophylactic mastectomy; predictive; private health insurance; patient-reported outcome; preoperative; independent variable; never smoker; breast-q; humans; prognosis; human; female; article; black person; married person; surveys and questionnaires; breast radiotherapy |
| Journal Title: | Annals of Surgical Oncology |
| Volume: | 31 |
| Issue: | 10 |
| ISSN: | 1068-9265 |
| Publisher: | Springer |
| Date Published: | 2024-10-01 |
| Start Page: | 6602 |
| End Page: | 6610 |
| Language: | English |
| DOI: | 10.1245/s10434-024-15310-z |
| PUBMED: | 39090496 |
| PROVIDER: | scopus |
| PMCID: | PMC12056762 |
| DOI/URL: | |
| Notes: | The MSK Cancer Center Support Grant (P30 CA008748) is acknowledge in the PDF -- Corresponding authors is MSK author: Jonas A. Nelson -- Source: Scopus |
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