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Understanding the Health Burden of Macromastia: Normative Data for the BREAST-Q Reduction Module

Mundy, Lily R. M.D.; Homa, Karen Ph.D.; Klassen, Anne F. D.Phil.; Pusic, Andrea L. M.D.; Kerrigan, Carolyn L. M.D., M.H.C.D.S.

Plastic & Reconstructive Surgery: April 2017 - Volume 139 - Issue 4 - p 846e–853e
doi: 10.1097/PRS.0000000000003171
Breast: Outcomes Article
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Background: The BREAST-Q Reduction module evaluates outcomes in reduction mammaplasty. However, there are currently no published normative scores, limiting the interpretation of BREAST-Q data.

Methods: The BREAST-Q Reduction module was administered via the Army of Women, an online community of women (with and without breast cancer) engaged in breast-cancer related research. Normative data were generated from women aged 18 years and older, without a history of breast cancer or breast surgery. Data analysis was performed using descriptive statistics and a linear multivariate regression. Generated normative data were compared to published BREAST-Q Reduction findings.

Results: The preoperative version of the BREAST-Q Reduction module was completed by 1206 women. Participant mean age was 55 ± 13 years, mean body mass index was 27 ± 6 kg/m2, and 40 percent (n = 481) had a bra cup size ≥ D. Mean normative scores were as follows: Satisfaction with Breasts, 57 ± 16; Psychosocial Well-being, 68 ± 19; Sexual Well-being, 55 ± 19; and Physical Well-being, 76 ± 11. Normative scores were lower in women with body mass index ≥ 30 and bra cup size ≥ D. In comparison to normative Army of Women scores, published BREAST-Q scores for women undergoing reduction mammaplasty were lower (worse) for preoperative patients and higher (better) for postoperative patients.

Conclusion: These new Army of Women normative data provide insights into breast-related satisfaction and well-being in women not pursuing breast reduction, giving new clinical context to better understand the health burden of macromastia, and to demonstrate the value of reduction mammaplasty in certain patients.

Durham, N.C.; Lebanon, N.H.; New York, N.Y.; and Hamilton, Ontario, Canada

From the Division of Plastic and Reconstructive Surgery, Duke University; the Division of Plastic Surgery, Dartmouth Hitchcock Medical Center; the Plastic and Reconstructive Service, Memorial Sloan Kettering Cancer Center; and McMaster University.

Received for publication July 15, 2016; accepted September 7, 2016.

Disclosure: The BREAST-Q is owned by Memorial Sloan-Kettering Cancer Center. Dr. Pusic and Dr. Klassen are co-developers. They receive a portion of licensing fees when the BREAST-Q is used in industry sponsored clinical trials. Dr. Andrea Pusic received support through the NIH/NCI Cancer Center Support Grant P30 CA008748. Drs. Mundy, Homa, and Kerrigan have no commercial associations or financial disclosures.

A “Hot Topic Video” by Editor-in-Chief Rod J. Rohrich, M.D., accompanies this article. Go to and click on “Plastic Surgery Hot Topics” in the “Digital Media” tab to watch. On the iPad, tap on the Hot Topics icon.

Carolyn L. Kerrigan, M.D., M.H.C.D.S., Dartmouth-Hitchcock Medical Center, One Medical Center Drive, Lebanon, N.H. 03756,

©2017American Society of Plastic Surgeons