Evaluation of a priority grouping system for patients undergoing reduction mammaplasty

The consequences of an earlier published priority grouping system for reduction mammaplasty are described. The system is based on breast volume but gives priority to certain age groups (25 years or less and 60 years or more), asymmetry, and ptosis, whereas overweight is considered as a negative factor. Additional points are given for psychological or somatic symptoms, or both. A total of 210 patients, who had been operated on were evaluated, and based on their total priority score, patients were assigned to one of five priority groups. Only five of the patients operated on belonged to the two groups with the lowest priority which indicates that the grouping system is a useful tool for sorting waiting lists and making decisions about priorities. The impact of the age related score and the subjective extra score for somatic and psychological distress is, however, considerable and questionable. Most of the patients (57%) less than 21 years old were in the group with the highest priority. The mean time period between acceptance for operation and the actual operation is 14 months in this age and priority group, which is far less than any other group. We think that the main focus should be the actual size of the breast and we have therefore recently modified the grouping system and reduced the impact of age and variables based on subjective scoring.