Impact Of Comorbidities On Institution-specific Normative Data For The Breast-q Reconstruction Module: A Prospective Study
Kevin M. Klifto, PharmD, Pathik Aravind, MBBS, Wen Shen, MD, MPH, Gedge D. Rosson, MD, Michele A. Manahan, MD, MBA, Carisa M. Cooney, MPH.
The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
PURPOSE: The BREAST-Q has been used extensively to assess patient-reported breast surgery outcomes; however, breast satisfaction in a general female population is relatively unknown and prior research has not evaluated the impact of different comorbidities on scores. We sought to assess the impact of comorbidities on breast satisfaction and quality-of-life (QOL) in women without breast cancer or a history of breast surgery to establish normative BREAST-Q scores accounting for comorbidities.
METHODS: This is a prospective, single-center study. A preoperative BREAST-Q reconstruction module and demographic form were administered to consecutive female participants who presented for routine gynecology appointments. Eligible patients were women with no history of breast cancer or breast surgery. Differences were compared between participants who did and did not have these comorbidities at the time of BREAST-Q completion using linear multivariate regression.
RESULTS: We included 300 female participants (cardiovascular disease=56, immunologic disease=17, pulmonary disease=28, gastrointestinal disease=32, neurological disease=4, endocrine disease=36, genitourinary disease=16, psychiatric disease=52, hematologic disease=7, musculoskeletal disease=42). Compared to other comorbidities, neurological disease (p=0.026) and gastrointestinal disease (p=0.039) were associated with lower Satisfaction with Breasts scores. Psychiatric disease was associated with lower Psychosocial Well-being scores (p<0.0001). Hematologic disease was associated with lower Physical Well-being: Chest scores (p=0.005). Musculoskeletal disease was associated with lower Physical Well-being: Chest scores (p=0.043) and Physical Well-being: Abdomen scores (p=0.036).
CONCLUSIONS: The presence of neurological, gastrointestinal, psychiatric, hematologic, and musculoskeletal comorbidities were associated with significantly lower BREAST-Q scores. The
influence of comorbidities on QOL and satisfaction scores may demonstrate validated outcome measures are not as robust as previously thought.
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