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Normative Data for Interpreting the BREAST-Q: Augmentation

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 and Reconstructive Surgery: April 2017 - Volume 139 - Issue 4 - p 846–853
doi: 10.1097/PRS.0000000000003186
Cosmetic: Outcomes Article
Psychosocial Insights

Background: The BREAST-Q is a rigorously developed, well-validated, patient-reported outcome instrument with a module designed for evaluating breast augmentation outcomes. However, there are no published normative BREAST-Q scores, limiting interpretation.

Methods: Normative data were generated for the BREAST-Q Augmentation module by means of the Army of Women, an online community of women (with and without breast cancer) engaged in breast-cancer related research. Members were recruited by means of e-mail; women aged 18 years or older without a history of breast cancer or breast surgery were invited to participate. Descriptive statistics and a linear multivariate regression were performed. A separate analysis compared normative scores to findings from previously published BREAST-Q augmentation studies.

Results: The preoperative BREAST-Q Augmentation module was completed by 1211 women. Mean age was 54 ± 24 years, the mean body mass index was 27 ± 6 kg/m2, and 39 percent (n = 467) had a bra cup size of D or greater. Mean scores were as follows: Satisfaction with Breasts, 54 ± 19; Psychosocial Well-being, 66 ± 20; Sexual Well-being, 49 ± 20; and Physical Well-being, 86 ± 15. Women with a body mass index of 30 kg/m2 or greater and bra cup size of D or greater had lower scores. In comparison with Army of Women scores, published BREAST-Q augmentation scores were lower before and higher after surgery for all scales except Physical Well-being.

Conclusions: The Army of Women normative data represent breast-related satisfaction and well-being in women not actively seeking breast augmentation. These data may be used as normative comparison values for those seeking and undergoing surgery as we did, demonstrating the value of breast augmentation in this patient population.

Psychosocial Insights for this Article is on Page 852.

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

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

Received for publication July 27, 2016; accepted September 19, 2016.

Disclosure: Funding for the study was provided from a discretionary account of Dr. Kerrigan’s held by The Dartmouth Institute. 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. 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.

Carolyn L. Kerrigan, M.D., M.H.C.D.S., The Dartmouth Institute, Geisel School of Medicine, Dartmouth College, Dartmouth-Hitchcock Medical Center, One Medical Center Drive, Lebanon, N.H. 03756,

©2017American Society of Plastic Surgeons