title: Patient-reported quality-of-life outcomes of breast reduction evaluated with generic questionnaires and the breast reduction assessed severity scale.
abstract: BACKGROUND
  The effects of breast reduction on quality of life (QOL) have been evaluated in patients with macromastia, but few investigators have performed condition-specific assessments.
  
  
  OBJECTIVE
  The authors employed generic and condition-specific questionnaires to examine the QOL of patients with macromastia and determined the responsiveness of the Turkish version of Breast Reduction Assessed Severity Scale (BRASS).
  
  
  METHODS
  This prospective cohort study included patients with breast hypertrophy who underwent breast reduction (n = 94). Patients completed the Turkish versions of the Medical Outcomes Study 36-Item Short Form Health Survey (SF-36), the BRASS, and the Rosenberg Self-Esteem Scale preoperatively and 4 months postoperatively. Differences in responses were evaluated by paired t-test and by comparing change effect sizes. Multiple regression analyses were performed to evaluate improvements in QOL in response to adjustments in baseline differences across patients.
  
  
  RESULTS
  Preoperative and postoperative questionnaires were completed by 78 patients (83%). Significant postoperative improvements in self-esteem (Rosenberg Self-Esteem Scale; P < .001) and in all domains of the BRASS (P < .001) were noted. Mean preoperative scores for 5 of 8 domains in the SF-36 were lower than those of a normative population. Postoperatively, all 5 mean scores improved significantly, but the score for bodily pain remained less than that of a normative population.
  
  
  CONCLUSIONS
  The results of this study indicate significant improvements in health-related QOL at 4 months after breast reduction in a population of patients with macromastia. The authors also demonstrate excellent responsiveness of the BRASS.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Izmir Education. yavuz.kececi@gmail.com
authors.forename: Yavuz
authors.initials: Y
authors.lastname: Kececi
authors.forename: Emin
authors.initials: E
authors.lastname: Sir
authors.forename: Melike
authors.initials: M
authors.lastname: Gungor
mesh_terms: D000328:Adult; D000368:Aged; D015992:Body Mass Index; D001940:Breast / Q000002:abnormalities* / Q000601:surgery; D005260:Female; D006304:Health Status; D006801:Humans; D006984:Hypertrophy / Q000523:psychology* / Q000601:surgery*; D016462:Mammaplasty / Q000523:psychology*; D008603:Mental Health; D008875:Middle Aged; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011788:Quality of Life; D015203:Reproducibility of Results; D012649:Self Concept; D057566:Self Report; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires / Q000592:standards*; D014421:Turkey