Interpreting the BREAST-Q for Breast-Conserving Therapy: Minimal Important Differences and Clinical Reference Values

Area of Science:

• Oncology
• Patient-Reported Outcomes
• Health Services Research

Background:

• The BREAST-Q is vital for assessing patient satisfaction and quality of life in breast-conserving therapy (BCT).
• Clinical interpretation of BREAST-Q scores is limited by a lack of established reference values and minimal important differences (MIDs).

Purpose of the Study:

• To determine reference values for the BREAST-Q BCT module.
• To establish the minimal important difference (MID) for the BREAST-Q BCT module.

Main Methods:

• A retrospective review of 8060 BCT patients from Memorial Sloan Kettering Cancer Center (2011-2021) was conducted.
• Descriptive statistics summarized median BREAST-Q scores, and distribution-based analyses estimated MIDs using 0.2 standard deviation and 0.2 standardized response mean.
• MIDs were also assessed across clinical subgroups including body mass index, radiation, and reexcision.

Main Results:

• Median BREAST-Q scores generally improved and stabilized by 2 years post-surgery, with the exception of Physical Well-Being of the Chest.
• A score interpretation tool, the Real-Time Engagement and Communication Tool, was developed based on percentile score trajectories.
• Estimated MIDs ranged from 3 to 5 points, with 4 points identified as appropriate for clinical and research use.

Conclusions:

• Establishing reference values and MIDs is essential for accurate BREAST-Q score interpretation in BCT patients.
• Improved interpretation can enhance clinical decision-making and research methodology in breast cancer care.
• Further validation of these findings in diverse patient populations is recommended.