Quick Calculation of Breast Resection Mass Using the Schnur Scale

Area of Science:

• Plastic Surgery
• Medical Economics

Background:

• The Schnur Sliding Scale, established in 1991, correlates breast tissue weight for reduction surgery with patient Body Surface Area (BSA).
• This scale categorizes patients into medical, review, or cosmetic groups, influencing insurance preauthorization for reduction mammaplasty.
• It is widely adopted by insurance companies, particularly in the western US, impacting surgical access.

Purpose of the Study:

• To simplify the calculation of the minimum breast tissue resection weight required by insurers.
• To develop a tool that aids surgeons in patient counseling and securing insurance reimbursement for reduction mammaplasty.
• To critically evaluate the impact of the Schnur Sliding Scale on patient access to necessary surgical procedures.

Main Methods:

• Combined the original Schnur Sliding Scale with its BSA nomogram into a simplified nomogram calculator.
• Developed a method using only patient height and weight for rapid calculation of anticipated tissue resection weight.
• Compared the accuracy and efficiency of manual calculation versus the simplified nomogram.

Main Results:

• The simplified nomogram allows for quick determination of the insurer-required tissue resection weight using basic patient measurements.
• Demonstrated the practical application and ease of use of the new nomogram calculator.
• Highlighted evidence suggesting the current scale may be prohibitive for symptomatic patients.

Conclusions:

• The simplified Schnur Sliding Scale nomogram facilitates easier determination of minimum breast resection weights.
• This tool can improve pre-operative patient counseling and assist surgeons in navigating insurance reimbursement processes.
• The study advocates for re-evaluation of the Schnur Sliding Scale's application due to potential barriers for patients requiring reduction mammaplasty.