BREAST-Q Under the Microscope: A Scoping Review of Reporting Gaps in Breast Surgery

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ID: 318300
2026
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Abstract
Abstract Background The BREAST-Q was developed to address a gap in breast surgery outcomes research as a validated, procedure-specific patient-reported outcome measure that assesses satisfaction and health related quality of life. Despite its global adoption, reporting practices remain inconsistent. Evaluating the application of the BREAST-Q post-mastectomy reconstruction and cosmetic breast surgery populations is essential to enhance consistency and comparability of outcomes. Objectives To examine how BREAST-Q domains are reported across breast surgery studies and to compare reported outcomes between post-mastectomy reconstruction and cosmetic breast surgery populations. Methods Five databases were searched from January 1, 2009 through September 16, 2022 for studies utilizing patient-reported outcome measures in breast surgery: PubMed (non-MEDLINE citations only), MEDLINE, PsycINFO, Scopus, and Web of Science. Of the 6,921 unique records identified, a total of 307 studies met criteria for inclusion in this scoping review. Eligible studies were English-language articles reporting mean BREAST-Q results on a standardized 0-100 scale in patients undergoing post-mastectomy reconstruction, breast augmentation, or breast reduction. Studies were categorized as Group 1 (Post-Mastectomy Reconstruction) or Group 2 (Cosmetic Breast Surgery). Extracted data included publication year, country, sample size, BREAST-Q means ± SD, domain coverage (% articles and % patients), and reporting trends across populations. All analyses were descriptive in nature, and no direct statistical comparisons between groups were performed due to heterogeneity in study design, patient populations, and follow-up intervals. Results In both groups, the most frequently reported BREAST-Q domains were Psychosocial Well-Being, Satisfaction with Breasts, and Sexual Well-Being (Group 1: 79.12%, 91.21%, and 77.29%; Group 2: 74.55%, 96.36%, and 83.64%, respectively). The aggregate global weighted mean BREAST-Q score was numerically higher in Group 2 than in Group 1 (81.99 vs. 74.49). These values represent descriptive aggregated study-level estimates and are not intended as direct statistical comparisons between groups. Conclusions Although the BREAST-Q is widely used, its results are not reported uniformly across domains, with certain domains emphasized disproportionately. Selective domain reporting introduces bias and limits comparability. Comprehensive reporting of each domain or provision of an overall BREAST-Q summary score would yield a more complete and unbiased assessment of patient satisfaction, consistent with the instrument’s intended purpose.
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Authors Gabriela Fioranelli, Nicole Alvarez, Jace Boswell, Ton Doan, Leslie Christense, Doruk Orgun, Aaron M. Dingle
Journal Aesthetic Surgery Journal Open Forum
Year 2026
DOI
10.1093/asjof/ojag127
URL
https://doi.org/10.1093/asjof/ojag127
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