BREAST-Q Under the Microscope: A Scoping Review of Reporting Gaps in Breast Surgery

The BREAST-Q was developed to address a gap in breast surgery outcomes research as a validated, procedure-specific patient-reported outcome measure (PROM) that assesses satisfaction and health related quality of life. Despite global adoption, reporting practices remain inconsistent. This review evaluated how BREAST-Q domains are reported and compated outcomes between postmastectomy reconstruction and cosmetic breast surgery populations. Five databases (PubMed, MEDLINE, PsycINFO, Scopus, and Web of Science) were searched from January 1, 2009 to September 16, 2022. Of 6921 records, 307 studies met inclusion criteria. Eligible studies reported mean BREAST-Q scores (0-100 scale) in patients undergoing postmastectomy reconstruction, breast augmentation, or breast reduction. Studies were grouped as reconstruction (Group 1) or cosmetic (Group 2). Extracted data included publication year, country, sample size, BREAST-Q means ± standard deviation and domain coverage. Analyses were descriptive due to heterogeneity in design, populations, and follow-up The most frequently reported domains in both groups were psychosocial well-being, satisfaction with breasts, and sexual well-being (Group 1: 79.12%, 91.21%, and 77.29%; Group 2: 74.55%, 96.36%, and 83.64%). The aggregate global weighted mean BREAST-Q score was higher in Group 2 than in Group 1 (81.99 vs 74.49), Though these values represent descriptive estimates, not direct comparisons. Although widely used, BREAST-Q reporting is inconsistent, with disproportionate emphasis on select domains. This selective reporting introduces bias and limits comparability. Comprehensive reporting across all domains, or inclusion of an overall summary score, would better reflect patient satisfaction and align with the instrument's intended purpose. Level of Evidence: 3 (Therapeutic).