title: Clinical outcomes in reduction mammaplasty: a systematic review and meta-analysis of published studies.
abstract: This systematic review and meta-analysis were undertaken to determine whether reduction mammaplasty improves measurable outcomes in women with breast hypertrophy. A systematic review of the literature in 5 languages from 1985 until March 1999 was performed, and data were compared for meta-analysis. Eligible studies were both experimental and observational and involved women with preoperative physical and/or psychosocial signs and symptoms who underwent reduction mammaplasty for breast hypertrophy. Outcomes assessed were postoperative physical signs and symptoms such as shoulder pain, shoulder (bra strap) grooving, and quality-of-life domains, such as physical and psychological functioning, and were expressed primarily as risk differences (RDs). Twenty-nine studies of 4173 patients met all eligibility criteria. Reduction mammaplasty was associated with a statistically significant improvement in physical signs and symptoms involving shoulder pain (RD, 0.71 [95% confidence interval (CI), 0.62-0.80]); shoulder grooving (RD, 0.69 [95% CI, 0.60-0.78]); upper/lower back pain (RD, 0.59 [95% CI, 0.48-0.70]); neck pain (RD, 0.50 [95% CI, 0.37-0.64]); intertrigo (RD, 0.44 [95% CI, 0.34-0.54]); breast pain (RD, 0.36 [95% CI, 0.17-0.55]); headache (RD, 0.28 [95% CI, 0.11-0.46]); and pain/numbness in the hands (RD, 0.11 [95% CI, 0.04-0.18]). The quality-of-life parameter of physical functioning was also statistically significant (RD, 0.58 [95% CI, 0.44-0.71]), while psychological functioning was not significant (RD, 0.46 [95% CI, 0.00-1.00]). The evidence suggests that women undergoing reduction mammaplasty for breast hypertrophy have significant postoperative improvement in preoperative signs and symptoms, quality of life, or both.
authors.affiliation: MetaWorks Inc, 10 President's Landing, Medford, MA 02155, USA.
authors.forename: E B
authors.initials: EB
authors.lastname: Chadbourne
authors.forename: S
authors.initials: S
authors.lastname: Zhang
authors.forename: M J
authors.initials: MJ
authors.lastname: Gordon
authors.forename: E Y
authors.initials: EY
authors.lastname: Ro
authors.forename: S D
authors.initials: SD
authors.lastname: Ross
authors.forename: P L
authors.initials: PL
authors.lastname: Schnur
authors.forename: P R
authors.initials: PR
authors.lastname: Schneider-Redden
mesh_terms: D000328:Adult; D015992:Body Mass Index; D016001:Confidence Intervals; D005260:Female; D006801:Humans; D006984:Hypertrophy / Q000601:surgery*; D016462:Mammaplasty; D011788:Quality of Life; D016896:Treatment Outcome