May 1, 2009

What Influences Women’s Opinions On Breast Surgery?

The six major factors that affect how happy a woman feels with the outcome of her breast surgery have been uncovered. Researchers writing in the open access journal BMC Women's Health have determined that, as well as final breast appearance, there are five other major concerns that influence surgical satisfaction.

Andrea Pusic, from Memorial Sloan-Kettering Cancer Center, New York, led a team of researchers who interviewed 48 women who had undergone breast reduction, augmentation or reconstruction. She said, "Patient satisfaction with breast appearance was without doubt the key theme and is a salient factor in determining the success of breast surgery. However, other themes were also identified that related to the broadened notion of quality of life, including concepts such as physical, psychological and sexual well-being".

The authors found that breast conditions and breast surgery impact women in the following six main areas: satisfaction with breasts; satisfaction with overall outcome; psychosocial well-being; sexual well-being; physical well-being; and satisfaction with the process of care. Although these six themes were common to women in all three groups, the importance ascribed to each was seen to vary by surgical group. According to Pusic, "While physical well-being was of only limited importance to breast augmentation patients (only a few reported pain and discomfort post-operatively), it was often the main motivation behind breast reduction surgery (patients reported substantial pain and activity limitations pre-operatively), and was often an issue for women following breast reconstruction".

Pusic and her colleagues have used their framework to develop a new patient-reported outcome measure called the BREAST-Q© (, which consists of three procedure-specific modules (Augmentation, Reconstruction and Reduction). The authors hope that their findings may be used to guide the development of patient education materials and facilitate shared medical decision-making. They conclude, "The combination of extensive detailed qualitative research and modern psychometric methods make it possible to measure constructs, such as patient satisfaction, in a more clinically meaningful and scientifically robust way than has ever been done in this patient group".

* Satisfaction and quality of life in women who undergo breast surgery: a qualitative study. Anne F Klassen, Andrea L Pusic, Amie Scott, Jennifer Klok and Stefan J Cano. BMC Women's Health (in press)


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