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Wang AT, Panayi AC, Fischer S, Diehm YF, Tapking C, Hundeshagen G, Kneser U, Mastroianni M, Pomahac B, Haug V. Patient-Reported Outcomes After Reduction Mammoplasty Using BREAST-Q: A Systematic Review and Meta-Analysis. Aesthet Surg J 2023; 43:NP231-NP241. [PMID: 36411260 DOI: 10.1093/asj/sjac293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 10/23/2022] [Accepted: 10/25/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The BREAST-Q questionnaire reduction module is an established tool for outcomes after reduction mammoplasty. OBJECTIVES This systematic review and meta-analysis assess key parameters affecting pre- and postoperative scores, with specific foci on patient characteristics and tissue resection weights. METHODS This study was conducted per PRISMA guidelines. PUBMED (National Institutes of Health; Bethesda, MD), Google Scholar (Google; Mountain View, CA), and Web of Science (Clarivate Analytics; Philadelphia, PA) were searched. All studies published before August 1, 2021, were assessed for eligibility by 2 independent reviewers. Inclusion criteria were prospective or retrospective studies in 6 languages that reported quality of life after reduction mammoplasty employing the BREAST-Q questionnaire reduction module. Quality of included studies was assessed employing the Newcastle-Ottawa-Scale. Analysis was performed per Cochrane Collaboration and the Quality of Reporting of Meta-analyses guidelines. RESULTS A total of 28 papers were included in the systematic review, 13 for preoperative meta-analysis, and 17 for postoperative meta-analysis. Postoperative scores in all 3 quality of life domains (psychosocial, physical, and sexual well-being) and satisfaction with breasts increased significantly after reduction mammoplasty compared with preoperative scores. Satisfaction with breasts showed the greatest improvement, from 22.9 to 73.0. Preoperative scores were lower than normative data, with improvement to comparable scores as the healthy population postoperatively. Improvements in BREAST-Q scores did not correlate with patient comorbidities, complication rates, or amount of breast tissue resected. CONCLUSIONS Reduction mammoplasty provides marked improvement in BREAST-Q patient-reported quality of life as well established in literature. However, these improvements do not correlate with tissue resection weights, warranting further inquiry of insurance-defined resection requirements. LEVEL OF EVIDENCE: 3
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Zhu Y, Zhang Q, Gong T, Zhang P, Cheng B, Liu J, Ji C. Sports Bras Improve Chest Keloids but Outcomes Are Dependent on Breast Size: A Retrospective Analysis. Front Oncol 2022; 12:871115. [PMID: 35880163 PMCID: PMC9307974 DOI: 10.3389/fonc.2022.871115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 06/02/2022] [Indexed: 11/13/2022] Open
Abstract
Our study is a retrospective medical record review performed on 95 female keloid patients with the standard therapy combining complete surgical excision with superficial X-ray radiation. We aimed to analyze the relationship between breast size and treatment outcomes as well as the benefits of sports bras in the postoperative management of keloids. The results showed that the keloid score of no sports bra group was significantly worse than the score of sports bra group at 1-year follow-up. In addition, the large breast size group showed more significant improvement of keloid score when wearing sports bras. Our study highlights that continuous wearing a sports bra effectively reduces the skin tension of the postoperative incision and promotes recovery, especially for patients with large breast size.
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Affiliation(s)
- Yanting Zhu
- Department of Dermatology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
- Key Laboratory of Skin Cancer of Fujian Higher Education Institutions, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China
- Fujian Dermatology and Venereology Research Institute, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China
| | - Qiguo Zhang
- The Department of Dermatology, The First Affiliated Hospital of Xiamen University, Xiamen, China
| | - Ting Gong
- Central Laboratory, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Peng Zhang
- Department of Dermatology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
- Key Laboratory of Skin Cancer of Fujian Higher Education Institutions, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China
- Fujian Dermatology and Venereology Research Institute, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China
| | - Bo Cheng
- Department of Dermatology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
- Key Laboratory of Skin Cancer of Fujian Higher Education Institutions, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China
- Fujian Dermatology and Venereology Research Institute, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China
| | - Jian Liu
- Department of Dermatology MINE BUTY, Fuzhou, China
- *Correspondence: Chao Ji, ; Jian Liu,
| | - Chao Ji
- Department of Dermatology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
- Key Laboratory of Skin Cancer of Fujian Higher Education Institutions, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China
- Fujian Dermatology and Venereology Research Institute, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China
- *Correspondence: Chao Ji, ; Jian Liu,
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de Borja C, Chang CJ, Watkins R, Senter C. Optimizing Health and Athletic Performance for Women. Curr Rev Musculoskelet Med 2022; 15:10-20. [PMID: 35023069 PMCID: PMC8804053 DOI: 10.1007/s12178-021-09735-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/22/2021] [Indexed: 11/03/2022]
Abstract
PURPOSE OF REVIEW The exponential growth of women participating in competitive sports throughout the years was made possible through several initiatives by the International Olympic Committee and the passage and implementation of Title IX as a federal law in the United States. However, this positive trend towards gender equity in sports has not transpired for women in medicine, especially in fields that care for elite athletes. This current review will discuss specific areas that can be tailored to help female athletes prevent injuries and optimize their athletic performance. We will also highlight how increased female team physician representation in sports may help optimize care for female athletes. RECENT FINDINGS Female athletes are considered high risk for certain conditions such as ACL tears, patellofemoral pain syndrome, bone stress injuries, sport-related concussions, and sexual violence in sport. Addressing factors specific to female athletes has been found to be valuable in preventing injuries. Strength and conditioning can optimize athletic performance but remains underutilized among female athletes. Although diversity in healthcare workforce has been found to be beneficial for multiple reasons, women remain underrepresented in sports medicine. Increasing female team physician representation may positively impact care for female athletes. Team physicians must understand the physiologic, biomechanical, and anatomic factors that are unique to female athletes in order to tailor injury prevention programs and optimize their athletic performance. Advocating for gender equity in sports medicine to advance representation of women in the field will increase workforce diversity and promote excellence in sports medicine care.
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Affiliation(s)
- Celina de Borja
- Department of Orthopaedic Surgery, Division of Pediatric Orthopaedics, University of California, San Francisco, 1825 4th Street, 5th Floor, San Francisco, CA, 94158, USA.
| | - Cindy J Chang
- Department of Orthopaedic Surgery, Primary Care Sports Medicine, University of California, San Francisco, San Francisco, CA, 94158, USA
| | - Rhonda Watkins
- Department of Orthopaedic Surgery, Division of Pediatric Orthopaedics, University of California, San Francisco, 1825 4th Street, 5th Floor, San Francisco, CA, 94158, USA
| | - Carlin Senter
- Department of Orthopaedic Surgery, Primary Care Sports Medicine, University of California, San Francisco, San Francisco, CA, 94158, USA
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Nicklaus KM, Bui T, Bordes MC, Liu J, Chopra D, Hoffman AS, Reece GP, Hanson SE, Merchant FA, Markey MK. Goldilocks Principle: Preference for Change in Breast Size in Breast Cancer Reconstruction Patients. Front Psychol 2021; 12:702816. [PMID: 34539505 PMCID: PMC8446205 DOI: 10.3389/fpsyg.2021.702816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 08/11/2021] [Indexed: 11/17/2022] Open
Abstract
Patients' preferences regarding changing or maintaining their breast size after mastectomy and reconstruction are important but understudied determinants of post-surgical satisfaction and quality of life. The goal of this study was to identify factors associated with preferences for changing or maintaining breast size for women undergoing breast reconstruction at The University of Texas MD Anderson Cancer Center in the United States from 2011 to 2014. The average age of participants was 45.7 ± 9.1 years. At baseline, mean average breast volumes were 755.7 ± 328.4 mL for all women (n = 48), 492.3 mL ± 209.3 for 13 women who preferred to be "bigger than now," 799.2 mL ± 320.9 for 25 women who preferred to remain "about the same," and 989.3 mL ± 253.1 for 10 women who preferred "smaller than now." Among the 23 women who preferred to change their breast size, 19 desired to shift toward the mean. Women with the smallest and largest 20% of baseline breast size were more likely to desire a change toward the mean (p = 0.006). Multinomial logistic regression models found average breast volume and satisfaction with breast size to be the most important factors associated with preferences for changing or maintaining breast size for women undergoing breast reconstruction. This study provides preliminary evidence for a "Goldilocks principle" in women's preferences for breast size change in the context of breast reconstruction, and identifies hypotheses for future studies of the associations among preference for change in breast size, preference achievement, and post-reconstruction body image.
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Affiliation(s)
- Krista M. Nicklaus
- Department of Biomedical Engineering, The University of Texas at Austin, Austin, TX, United States
- Department of Plastic Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Thao Bui
- Department of Engineering Technology, University of Houston, Houston, TX, United States
| | - Mary Catherine Bordes
- Department of Plastic Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Jun Liu
- Department of Plastic Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Deepti Chopra
- Department of Psychiatry, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Aubri S. Hoffman
- Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Gregory P. Reece
- Department of Plastic Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Summer E. Hanson
- Section of Plastic and Reconstructive Surgery, University of Chicago Medicine and Biological Sciences, Chicago, IL, United States
| | - Fatima A. Merchant
- Department of Biomedical Engineering, The University of Texas at Austin, Austin, TX, United States
- Department of Engineering Technology, University of Houston, Houston, TX, United States
| | - Mia K. Markey
- Department of Biomedical Engineering, The University of Texas at Austin, Austin, TX, United States
- Department of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
- *Correspondence: Mia K. Markey,
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