Secondary Logo

Journal Logo

Institutional members access full text with Ovid®

Prospective Evaluation of Health After Breast Reduction Surgery Using the Breast-Q, Short-Form 36, Breast-Related Symptoms Questionnaire, and Modified Breast Evaluation Questionnaire

Lewin, Richard MD, PhD; Lidén, Mattias MD, PhD; Lundberg, Jonas MD, PhD; Hansson, Emma MD; Selvaggi, Gennaro MD; Thorarinsson, Andri MD, PhD; Elander, Anna MD

doi: 10.1097/SAP.0000000000001849
Breast Surgery

Introduction Breast hypertrophy is a condition associated with physical, psychological, and psychosocial problems. The primary aims of this study were to determine the impact of breast hypertrophy and the effects of breast reduction, performed on the basis of well-described inclusion criteria, on general and breast-related health, using both general and diagnosis-specific validated questionnaires. We used a prospective, longitudinal paired study design. A secondary aim was to analyze the relationship between preoperative breast volume, body mass index, sternal notch-to-nipple distance and the weight of resected tissue on the one hand and improvements in health on the other.

Methods Three hundred forty-eight consecutive patients undergoing breast reduction were included and the Short-Form 36 (SF-36), Breast-Related Symptoms Questionnaire (BRSQ), Modified Breast Evaluation Questionnaire (mBEQ) and BREAST-Q were distributed preoperatively and 1 year postoperatively.

Results A total of 284 (83%) patients answered the questionnaires either preoperatively or postoperatively, or both, and 159 (46%) patients answered both. The breast hypertrophy patients had significantly lower scores preoperatively than the matched normal population when it came to all dimensions of the SF-36 and mBEQ. The preoperative scores for both the BRSQ and BREAST-Q were low.

After breast reduction, there were significant improvements in all dimensions of the BRSQ, mBEQ, and Breast-Q and in several dimensions of the SF-36.

Conclusions Breast reduction reduces or removes disease-associated pain. It improves or normalizes perceived health and psychosocial self-esteem in slightly obese women or women of normal weight with preoperative breast volumes around 1000 mL. Women with higher preoperative breast volumes and longer sternal notch-to-nipple distances appear to be more satisfied with the cosmetic result postoperatively.

From the Department of Plastic Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.

Received May 19, 2018, and accepted for publication, after revision December 27, 2018.

Conflicts of interest and sources of funding: none declared.

Reprints: Richard Lewin, MD, PhD, Sahlgrenska University Hospital, Gröna stråket 7, 413 46 Gothenburg, Sweden. E-mail:

Online date: May 23, 2019

Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.