Real-Time Integration of Patient-Reported Outcomes in Breast Cancer Surgery: Feasibility of the BREAST-Q REACT

Patient-reported outcomes (PROs) are central to evaluating quality of life after breast cancer surgery, yet they rarely inform real-time perioperative care. We developed the BREAST-Q Real-time Engagement and Communication Tool (REACT), a dashboard that contextualizes individual BREAST-Q scores against reference values and generates prompts for timely intervention when scores fall below the 25 th percentile. This study evaluated the feasibility of implementing REACT into routine surgical workflows and gives an early examination of impact. Between November 2024 and February 2025, a single center randomized feasibility trial was conducted among women undergoing breast-conserving surgery or mastectomy with immediate reconstruction. Participants were randomized 1:1 to standard feedback or feedback enhanced with REACT. Feasibility endpoints included recruitment, survey completion, and actionability of referrals. Of 82 patients screened, 69 enrolled (84.1%). Among those with low BREAST-Q scores (N = 25), 52% received timely referrals, meeting predefined feasibility criteria. At six-weeks postoperatively, median BREAST-Q Physical Well-Being of the Chest scores were higher in the REACT group than in controls (76 versus 60, p = 0.026), with physical-therapy referrals occurring more often (33% versus 24%) and earlier (1.7 months versus 3.2 months). However, survey completion was limited by an institutional electronic-medical-record transition, limiting follow up data beyond 6 weeks. BREAST-Q REACT proved feasible, actionable, and potentially related to earlier intervention and improved short-term recovery. Embedding real-time PRO dashboards into perioperative care represents a scalable model for patient-centered surgical practice and demonstrates the potential of PROMs to evolve from retrospective research data into actionable clinical tools.