title: Measurement of breast volume is a useful supplement to select candidates for surgical breast reduction.
abstract: BACKGROUND
  The indication for breast reduction in a public welfare or an insurance paid setting depends on the severity of the subjective symptoms and the clinical evaluation. The purpose of this study was to evaluate the use of breast volume as an objective criterion to establish the indication for breast reduction surgery, thus establishing a standard decision basis that can be shared by surgeons and departments to secure patients fair and equal treatment opportunities.
  
  
  METHODS
  A total of 427 patients who were referred to three Danish public hospitals with breast hypertrophy in the period from January 2007 to March 2011 were included prospectively in the study. The patients' subjective complaints, height, weight and standard breast measurements were registered as well as the decision for or against surgery. Breast volume was measured using transparent plastic cups.
  
  
  RESULTS
  Cut-off values for breast volume were calculated based on whether or not the patients were offered reduction surgery. Most patients (93%) with a breast volume below 800 cc were not offered surgery, while most with a volume exceeding 900 cc were offered surgery (94%). In the grey zone between 800 and 900 cc, the indication seemed to be less clear-cut, and additional parameters need to be included.
  
  
  CONCLUSIONS
  Breast volume can be used as an objective criterion in addition to the presently used criteria. Breast volume can easily be measured and has become appreciated by plastic surgeons dealing with patients with breast hypertrophy as a tool which facilitates their decision-making and patients' acceptance of the decisions made.
  
  
  BACKGROUND
  not relevant.
  
  
  BACKGROUND
  not relevant.
authors.affiliation: Kirurgisk Afdeling, Sydvestjysk Sygehus, Esbjerg, Finsensgade 35, 6700 Esbjerg, Denmark. peder.ikander@gmail.com.
authors.forename: Peder
authors.initials: P
authors.lastname: Ikander
authors.forename: Jennifer Berg
authors.initials: JB
authors.lastname: Drejøe
authors.forename: Pavia
authors.initials: P
authors.lastname: Lumholt
authors.forename: Helle
authors.initials: H
authors.lastname: Sjøstrand
authors.forename: Steen
authors.initials: S
authors.lastname: Matzen
authors.forename: Anne
authors.initials: A
authors.lastname: Quirinia
authors.forename: Hans Erik
authors.initials: HE
authors.lastname: Siersen
authors.forename: Anita
authors.initials: A
authors.lastname: Ringberg
authors.forename: Susanne
authors.initials: S
authors.lastname: Lambaa
authors.forename: Lisbet Rosenkrantz
authors.initials: LR
authors.lastname: Hölmich
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001940:Breast / Q000002:abnormalities* / Q000473:pathology* / Q000601:surgery; D003661:Decision Support Techniques; D005260:Female; D006801:Humans; D006984:Hypertrophy / Q000473:pathology / Q000601:surgery*; D016462:Mammaplasty; D008875:Middle Aged; D009929:Organ Size; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D018579:Patient Selection; D011446:Prospective Studies; D055815:Young Adult