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Breast Reduction Surgery and Quality of Life and Clinical Outcomes

  • A. Thoma
  • L. McKnight
Reference work entry

Abstract:

 Breast hypertrophy is a common condition seen by plastic surgeons. Patients with this condition complain of upper back, neck and shoulder discomfort and sometimes chronic headaches. They also have trouble finding proper clothing and have difficulties participating in sport activities. Therefore, this condition carries important burdens in health-related quality of life (HRQL).  Breast reduction surgery is the solution to this problem. However, this procedure remains controversial in some geographic jurisdictions because third party payers refuse to pay for it. Also, rather arbitrarily, some plastic surgeons refuse to perform this surgery on overweight patients with this condition. This chapter provides an up-to-date review of the breast reduction studies in which quality of life was the primary outcome measure. The studies considered in this review covered the spectrum of the level of evidence, from case series to  systematic reviews. The majority of publications, however, fell into the lower levels of the evidence (i.e., cohort and  case control studies). All published studies, irrespective of study design demonstrated substantial improvements in quality of life in women who undergo breast reduction surgery. The recent evidence suggests that overweight patients with breast hypertrophy benefit from breast reduction just as much as thin patients with breast hypertrophy. Additionally, the mean  quality-adjusted life years (QALY) gained per patient because of the surgery was 0.12 during the 1-year follow-up period. The health-related quality-of-life (HRQL) effect of the surgery translates into an expected lifetime gain of 5.32 QALYs, which is equivalent to each patient living an additional 5.32 years in perfect health.

Keywords

Breast Reduction Health Utility Index Reduction Mammaplasty Breast Reduction Surgery Health Status Classification System 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

List of Abbreviations:

QOL

quality of life

HRQL

health related quality of life

RCT

 randomized controlled trial

HUI 2/3

health utilities index mark 2/3

SF-36

short form 36 health survey questionnaire

STAI

state–trait anxiety inventory

MBSRQ

multidimensional body-self relations questionnaire

MPQ

McGill pain questionnaire

BRS

breast-related symptoms

GHQ12

general health questionnaire

STAI

state-trait anxiety index

RSE

Rosenberg self-esteem scale

SCS

self-consciousness scale

DAS-59

Derriford appearance scale 59

EQ-5D

European quality of life-5 dimensions

FPQ

Finnish pain questionnaire

FBAS

Finnish breast-associated symptoms questionnaire

15D

15D quality of life questionnaire

HADS

hospital anxiety and depression score

FANLT

functional assessment of non-life threatening conditions version 4

EPQ-R

Eysenck personality questionnaire-revised

HAQ-20

The Stanford health assessment questionnaire

DBPT

digital-body-photo-test

CAPT

color-a-person body dissatisfaction test

SQLP

subjective quality of life profile

NASS

The North American Spine Society Lumbar Spine Outcome Assessment Instrument

BSI

breast symptom inventory

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Copyright information

© Springer Science+Business Media LLC 2010

Authors and Affiliations

  • A. Thoma
  • L. McKnight

There are no affiliations available

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