Plastic and Reconstructive Surgery Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Breast Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Ann Surg Oncol. 2023 Jul;30(7):4075-4084. doi: 10.1245/s10434-023-13222-y. Epub 2023 Feb 25.
The BREAST-Q is an important tool for evaluating patient satisfaction and quality of life in breast-conserving therapy (BCT) patients, but its clinical utility is limited by the lack of guidance on score interpretation. This study determines reference values and the minimal important difference (MID) for the BREAST-Q BCT module.
A retrospective review of BCT patients at Memorial Sloan Kettering Cancer Center from January 2011 to December 2021 was performed. Descriptive statistics were used to summarize median BREAST-Q scores. Distribution-based analyses estimated MIDs based on 0.2 standard deviation of baseline BREAST-Q scores and 0.2 standardized response mean of the difference between baseline and 1-year postoperative BREAST-Q scores. MIDs for different clinical groupings based on body mass index, radiation, and reexcision also were estimated.
Overall, 8060 patients were included for determining reference values, and 5673 patients were included for estimating MIDs. Median BREAST-Q scores trended upwards and stabilized by 2 years after surgery for all domains except Physical Well-Being of the Chest, which decreased and stabilized by 2 years. A score interpretation tool, the Real-Time Engagement and Communication Tool, was created based on 25th percentile, median, and 75th percentile scores trajectories. All MID estimates ranged from 3 to 5 points; 4 points was determined to be appropriate for use in clinical practice and research.
Reference values and MIDs are crucial to BREAST-Q score interpretation, which can lead to improved clinical evaluation and decision making and improved research methodology. Future research should validate this study's findings in different patient cohorts.
BREAST-Q 是评估保乳治疗（BCT）患者满意度和生活质量的重要工具，但由于缺乏评分解释的指导，其临床实用性受到限制。本研究确定了 BREAST-Q BCT 模块的参考值和最小有意义差异（MID）。
对纪念斯隆凯特琳癌症中心 2011 年 1 月至 2021 年 12 月期间的 BCT 患者进行回顾性审查。使用描述性统计来总结 BREAST-Q 评分的中位数。基于基线 BREAST-Q 评分的 0.2 标准差和基线与 1 年术后 BREAST-Q 评分差值的 0.2 标准化反应均值，进行基于分布的分析以估计 MID。还根据体重指数、放疗和再次切除术对不同临床分组估计 MID。
总体而言，有 8060 例患者被纳入确定参考值，有 5673 例患者被纳入估计 MID。除胸部生理健康外，所有领域的 BREAST-Q 评分在手术后 2 年内呈上升趋势并趋于稳定，胸部生理健康评分在 2 年内下降并趋于稳定。根据 25 百分位、中位数和 75 百分位得分轨迹，创建了一个名为“实时参与和沟通工具”的评分解释工具。所有 MID 估计值范围在 3 至 5 分之间；确定 4 分适合在临床实践和研究中使用。
参考值和 MID 对于 BREAST-Q 评分解释至关重要，这可以提高临床评估和决策制定的质量，并改善研究方法。未来的研究应在不同的患者群体中验证本研究的结果。
