American Association of Plastic Surgeons Meeting 2022

Patient-Reported Outcomes As A Clinical Vital Sign: Breast-Q Implementation Lessons And Clinical Reference Values

Purpose

•To describe institutional improvements to BREAST-Q implementation in clinical practice through increasing patient engagement and creating reference values

Background

•BREAST-Q is a frequently used patient-reported outcome measure for satisfaction and quality of life following breast reconstruction.

•Routine, longitudinal implementation of BREAST-Q has been challenging à BREAST-Q underutilized in patient care

•Reference values and strategies to engage patients can improve BREAST-Q clinical utility.

Methods

•Retrospective review of BREAST-Q completion rates of postmastectomy breast reconstruction patients at Memorial Sloan Kettering Cancer Center (MSK) in 2011-2020.

•Descriptive statistics of MSK BREAST-Q scores to generate reference values

•External validation of reference values by comparing to BREAST-Q scores from Mastectomy Reconstruction Outcomes Consortium (MROC)

Results

•109,435 requested BREAST-Qs à 41,981 BREAST-Qs completed

•Responders were younger, more likely to be white, and more likely to have private insurance than non-responders.

•MSK: n=3268, 2932 implant, 336 autologous

•MROC: n=2814, 1958 implant, 856 autologous

•No meaningful differences in cohort characteristics, including age, race, diabetes, smoking status, chemotherapy, and radiation.

Conclusions

•Sustained, longitudinal implementation of BREAST-Q for clinical practice is possible.

•REACT adds to the clinical applicability of BREAST-Q by providing context to a numerical score à target patients with concerning scores for intervention

•REACT validated for breast reconstruction patients in North America

American Association of Plastic Surgeons Meeting 2022

Patient-Reported Outcomes As A Clinical Vital Sign: Breast-Q Implementation Lessons And Clinical Reference Values

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