Patient-Reported Outcome Measures for Post-mastectomy Breast Reconstruction: A Systematic Review of Development and...

Area of Science:

• Oncology
• Plastic Surgery
• Health Outcomes Research

Background:

• Breast reconstruction (BR) aims to enhance patient outcomes post-mastectomy.
• A core outcome set for BR necessitates reliable and accurate patient-reported outcome measures (PROMs).
• Evaluating existing PROMs is crucial for selecting appropriate instruments for future BR studies.

Purpose of the Study:

• To systematically review the development and measurement properties of existing PROMs for breast reconstruction.
• To inform the selection of validated PROMs for a core measurement set in BR research.

Main Methods:

• A PRISMA-compliant systematic review assessed development and validation studies of BR PROMs.
• PROMs with adequate content validity underwent evaluation using the COSMIN Risk of Bias checklist.
• Measurement properties were assessed, and evidence quality was evaluated using a modified GRADE approach.

Main Results:

• Fourteen articles reported on six PROMs; only three met criteria for full evaluation: BREAST-Q, BRECON-31, and EORTC QLQ-BRECON-23.
• All three evaluated PROMs (BREAST-Q, BRECON-31, EORTC QLQ-BRECON-23) were robustly developed and validated.
• These three PROMs demonstrated adequate measurement properties and methodological quality.

Conclusions:

• BREAST-Q, BRECON-31, and EORTC QLQ-BRECON-23 are well-developed PROMs with adequate measurement properties for breast reconstruction.
• Consensus among stakeholders is required to recommend a specific PROM for the core measurement set.
• Standardized PROM selection will improve data reliability and comparability in future BR research.