Should breast reduction surgery be rationed? A comparison of the health status of patients before and after treatment: postal questionnaire survey.

OBJECTIVES

To assess the health status of patients before and after breast reduction surgery and to make comparisons with the health status of women in the general population.

DESIGN

Postal questionnaire survey sent to patients before and six months after surgery.

SETTING

The three plastic surgery departments in the Oxford Regional Health Authority, during April to August 1993.

SUBJECTS

166 women (over the age of 16 years) referred for breast reduction; scores from the "short form 36" (SF-36) health questionnaire completed by women in the 1991-2 Oxford healthy life survey.

MAIN OUTCOME MEASURES

Health status of breast reduction patients before and after surgery as assessed by the SF-36, the 28 item general health questionnaire, and Rosenberg's self esteem scale; comparisons between the health status of breast reduction patients and that of women in the general population; outcome of surgery as assessed retrospectively by patients.

RESULTS

Differences between the health status of breast reduction patients and that of women in the general population were detected by the SF-36 both before and after surgery. Breast reduction surgery produced substantial change in patients' physical, social, and psychological function. The proportion of cases of possible psychiatric morbidity according to the general health questionnaire fell from 41% (22/54) before surgery to 11% (6/54) six months after treatment. Eighty six per cent (50/58) of patients expressed great satisfaction with the surgical result postoperatively.

CONCLUSION

The study provides empirical evidence that supports the inclusion of breast reduction surgery in NHS purchasing contracts.