Chinese Women Recover Slower Than Western Women After Cancer-Related Breast Reconstruction: A Prospective Descriptive Study Using Patient-Reported Outcome Measurement for Breast Surgery

Abstract

Abstract Purpose: The patient-reported outcome measurement for breast surgery (BREAST-Q) has been widely used to assess the physical, psychosocial, and breast satisfaction of women undergoing breast reconstruction surgery. However, so far, there is no traditional Chinese version available. The study aims (1) to perform the psychometric evaluation of the traditional Chinese version of the BREAST-Q core and reconstruction modules and (2) to describe Chinese women’s experiences using the BREAST-Q. Methods: We first translated and pilot tested the BREAST-Q, then recruited patients (N = 155) undergoing silicone breast reconstruction surgery. Results: The BREAST-Q had Cronbach's alpha values of 0.87 and 0.92 for the pre- and post-surgical reconstruction versions, with a content validity index of 0.96 and 0.98, respectively. Having a normal BMI was only related to pre-operative psychosocial wellbeing and breast satisfaction. Compared to the BREAST-Q clinical references of the US population, we found that participants experienced consistently lower physical, psychosocial, and sexual quality of life before and after their breast reconstruction surgeries, and at the six-month follow-up, there were significant deteriorations in the physical, psychosocial, and breast satisfaction domains and no improvement in sexual wellbeing. Conclusion: The findings indicate that Chinese women are likely to be more vulnerable to the physical and psychosocial impact of changes in breast, including surgical breast reconstruction, than women in the US and thus experience a slower recovery process. Pre- and post-operative support should be designed to fit their unique survivorship trajectory.