Normative BREAST-Q Scores in Sub-Saharan African Women: Interpreting the Impact of Mastectomy and Reconstruction

Breast cancer is a leading cause of mortality among women in sub-Saharan Africa (SSA). As such, optimizing outcomes for treatment and reconstruction is a global health priority. Currently, normative data for interpreting BREAST-Q results are limited to high-income countries. This study seeks to evaluate baseline breast-related quality of life in SSA women without breast cancer and compare it with previously published normative values.

Women in Ghana, Nigeria, and Ethiopia 18 years of age and older with no history of breast cancer or breast surgery were recruited to complete the BREAST-Q preoperative mastectomy module. Multivariable regression was performed to identify correlations between sociodemographic variables and BREAST-Q scores. Comparisons were made between normative data previously published in high-income countries and within individual SSA populations.

Normative BREAST-Q scores were obtained from a total of 453 women (169 Ghanaian, 210 Nigerian, and 74 Ethiopian) with a mean age of 26 ± 7 years and body mass index of 26 ± 6 kg/m². Scores were as follows: satisfaction with breasts, 64 ± 26; psychosocial well-being, 63 ± 23; sexual well-being, 57 ± 26; and physical well-being, 68 ± 16. Compared with scores published in the United States, SSA women scored higher in breast satisfaction and lower in psychosocial and physical well-being. Significant differences in scores were also found among countries in SSA.

This study establishes normative values for the BREAST-Q mastectomy module in a group of women in SSA without breast cancer and found significant variability globally and among countries within the same region.