A Tool to Measure Reconstruction Satisfaction


The most important goal of breast reconstruction is to improve quality of life. Within the Plastic and Reconstructive Service at Memorial Sloan Kettering Cancer Center (MSK), we know that our success as surgeons is best measured by the satisfaction expressed by our patients. With this in mind, we developed the BREAST-Q, an innovative questionnaire designed to evaluate the outcomes of reconstructive breast surgery from the patient perspective.

Understanding What Matters

The BREAST-Q, created in 2009 with input from more than 2,000 patients, asks about the things that women told us are most important to them. More formally known as a patient-reported outcome measure, the questionnaire evaluates how well breasts match, how they feel to the touch, and how they look in different clothing. It also asks about quality of life following breast surgery. For example, the BREAST-Q evaluates how confident and comfortable a woman feels about her body  when she is with her partner. At MSK, all of our patients are asked to complete the BREAST-Q before and after surgery as a part of our routine clinical care. For every patient, our electronic system generates a comprehensive, personalized report. Our experienced team of physicians and nurses reviews these reports to better understand how patients are progressing and to address any issues they may be experiencing.

Several important factors affect expectations for breast reconstruction

Several important factors affect expectations for breast reconstruction

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Worldwide Application

Our Breast-Q patient satisfaction survey has led to significant improvements in care for breast cancer patients around the world.
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Today, the BREAST-Q is utilized by healthcare institutions, organizations, and government agencies around the world and has been translated into 13 languages.  It has served as the foundation of several important outcome studies aimed at answering such questions as what type of breast reconstruction is best and how radiation affects implants.

In 2011, more than 8,000 patients in the United Kingdom completed the BREAST-Q in conjunction with a government audit of breast surgery outcomes. The study led to significant improvements in the care that women receive in the UK. Additional BREAST-Q studies in Europe and South America are evaluating the impact of new techniques such as nipple-sparing mastectomy, fat grafting, and direct implant placement. In one recent BREAST-Q study involving approximately 7,000 patients and conducted by the Army of Women advocacy group, investigators were able to capture and report on long-term difference in outcomes across all types of breast cancer surgeries, including breast-conserving therapy.

The effective capture and measurement of objective data regarding quality of life after reconstructive surgery has been a critical movement, and MSK is very proud to have led the way. It’s extremely gratifying to have created a tool that has become so widely used and highly valued — one with the capacity to continually improve quality of life for women undergoing reconstructive breast surgery.

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