title: Reduction mammaplasty is effective treatment according to two quality of life instruments. A prospective randomised clinical trial.
abstract: OBJECTIVE
  Debate around reduction mammaplasty has continued due to lack of prospective randomised clinical trials (RCTs). Therefore, a prospective randomised clinical trial was designed to assess the effectiveness of reduction mammaplasty performed for symptomatic breast hypertrophy.
  
  
  METHODS
  82 patients were randomised, 40 patients to the operative group, and 42 patients to the nonoperative group. Groups were examined at 0 and 6 months. Instruments used were the Short Form-36 quality of life questionnaire (SF-36), the 15D quality of life questionnaire, the Finnish Breast-Associated Symptoms questionnaire (FBAS), and the Finnish Pain Questionnaire (FPQ). Analysis of covariance (ANCOVA) was applied for instrumental data comparison.
  
  
  RESULTS
  29 patients in the operative group and 35 patients in the nonoperative group completed the study. Mean age was 46 years. At second examination, the utility index score (SF-6D) and the physical summary score of SF-36, the index score of 15D, the breast-associated symptoms score of FBAS, and the pain score of FPQ demonstrated high significant statistical (P<0.0001) and clinical difference between groups. For the mental summary score of SF-36 findings were less significant statistically and clinically.
  
  
  CONCLUSIONS
  Reduction mammaplasty results in significant improvement of quality of life and decrease in pain and breast-associated symptoms. Future studies should be focused on patient selection and justification of the treatment by comparing with other approved treatments.
authors.affiliation: Department of Plastic Surgery, Helsinki University Central Hospital, HUS, Finland. kai.saariniemi@helsinki.fi
authors.forename: Kai M M
authors.initials: KM
authors.lastname: Saariniemi
authors.forename: Ulla H
authors.initials: UH
authors.lastname: Keranen
authors.forename: Paivi K
authors.initials: PK
authors.lastname: Salminen-Peltola
authors.forename: Hannu O M
authors.initials: HO
authors.lastname: Kuokkanen
mesh_terms: D000328:Adult; D001940:Breast / Q000473:pathology; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D006984:Hypertrophy / Q000601:surgery; D016462:Mammaplasty / Q000379:methods / Q000523:psychology* / Q000534:rehabilitation; D008875:Middle Aged; D010147:Pain Measurement / Q000379:methods; D011446:Prospective Studies; D011594:Psychometrics; D011788:Quality of Life; D016896:Treatment Outcome