Breast Cancer and Reconstruction: Normative Data for Interpreting the BREAST-Q

Background: The BREAST-Q is a patient-reported outcome instrument used to evaluate outcomes in patients undergoing breast cancer surgery and reconstruction. Normative values for the BREAST-Q breast cancer modules have not been established, limiting data interpretation. Methods: Participants were recruited by means of the Army of Women, an online community of women (with and without breast cancer), to complete Mastectomy, Breast Conserving Therapy, and Reconstruction preoperative BREAST-Q scales. Inclusion criteria were women aged 18 years or older without a history of breast surgery or breast cancer. Analysis included descriptive statistics, a linear multivariate regression, and a comparison of the generated normative data to previously published BREAST-Q findings. Results: The BREAST-Q was completed by 1201 women. The mean patient age was 54 +/- 13 years, mean body mass index 26 +/- 6 kg/m(2), and 38 percent (n = 455) had a bra cup size of D or greater. Mean +/- SD scores for BREAST-Q scales were as follows: Satisfaction with Breasts (58 +/- 18), Psychosocial Wellbeing (71 +/- 18), Sexual Well-being (56 +/- 18), Physical Well-being-Chest (93 +/- 11), and Physical Well-being Abdomen (78 +/- 20). Women with a body mass index of 30 kg/m(2) or greater, cup size of D or greater, age younger than 40 years, and annual income less than $40,000 reported lower scores. Comparing normative scores to published data in breast cancer patients, Satisfaction with Breasts scores were higher after autologous reconstruction and lower after mastectomy; Sexual Well-being scores were lower after mastectomy and breast conserving therapy; and Physical Well-being Chest scores were lower after mastectomy, breast conserving therapy, and reconstruction. Conclusion: These are the first published normative scores for the BREAST-Q breast cancer modules and provide a clinical reference point for the interpretation of data.