Table 3 Health-related quality of life
Author Year Country | Study design | Number of patients | Withdrawals—dropouts | Intervention Breast reduction Mean (SD) | Control No surgery Mean (SD) P values of intergroup difference if not state otherwise | Comments | Directness* | Study limitations* | Precision* |
|---|---|---|---|---|---|---|---|---|---|
Araujo 2014 Brazil [40] | RCT | 60 I: 30 C: 30 | 2 1: 0 C: 2 | SF-6D Median (range) Preop: 0.61 (0.45–0.83) 3 m: 0.75 (0.50–0.97) 6 m: 0.76 (0.44–0.97) | SF-6D Median (range) Preop: 0.61 (0.39–0.835) 3 m: 0.65 (0.43–0.83), p < 0.001 6 m: 0.63 (0.42–0.88) p = 0.008 | SF-6D: Short Form 6 Dimensions questionnaire. Scale 0.29–1.00 (1.00 denotes perfect health). Minimal important difference (MID) for SF-6D has been suggested to be in the range of 0.01 to 0.10 [35] (SF-36 measured but not reported) | ? | ? | ? |
Iwuagwu 2006 UK [31] | RCT | 73 I: 36 C: 37 | 0 I: 0 C: 0 | FANLT Physical well-being: 24.2 (3.7) Social well-being: 24.6 (4.7) Emotional well-being: 17.3 (3.7) Functional well-being: 23.3 (5.2) SF-36 Physical component score: 50.0 (7.5) Mental component score: 53.2 (8.8) EQ-5D Self-care: 1.03 (0.18) Activities: 1.32 (0.61) Pain: 1.46 (0.57) Anxiety and depression: 1.21 (0.50) | FANLT Physical well-being: 19.2 (5.1) p < 0.001 Social well-being: 20.7 (4.7) p = 0.002 Emotional well-being: 13.0 (3.5) p < 0.001 Functional well-being: 17.1 (6.2) p < 0.001 SF-36 Physical component score: 42.0 (9.6) p < 0.001 Mental component score: 42.0 (11.1) p < 0.001 EQ-5D Self-care: 1.05 (0.23) p = 0.978 Activities: 1.48 (0.51) p = 0.061 Pain: 2.05 (0.52) p < 0.001 Anxiety and depression: 1.59 (0.55) p = 0.006 | FANLT: Functional Assessment of Non-Life-Threatening Conditions (higher score = better health, range not stated) SF-36: Short Form-36 Health survey (36 items, range 0–100, higher score = better health) EQ-5D (EuroQol): The European Quality of Life-5 Dimensions (mobility, self-care, usual activities, pain/discomfort, anxiety/depression). Range 1–3, lower score = better. 4 dimensions reported in article All are validated HRQoL tools Control group underwent physiotherapy | ? | ? | ? |
Saariniemi 2008 Finland [34] | RCT | 82 I: 40 C: 42 | 18 I: 11 C: 7 | SF-36 Utility index score (SF-6D): 0.820 (SD NR) Physical component score: 51.7 (SD NR) Mental component score: 53.8 (SD NR) 15D index score 0.917 (SD NR) | SF-36 Utility index score (SF-6D): 0.663 (SD NR) MD 0.157 (95% CI 0.107 to 0.220) p < 0.0001 Physical component score: 43.3 (SD NR) MD 8.4 (95% CI 5.8 to 11.8) p < 0.0001 Mental component score: 46.2 (SD NR) MD 7.6 (95% CI 3.2 to 13.1) p < 0.002 15D index score 0.861 (SD NR) MD 0.056 (95% CI 0.041 to 0.103), p < 0.0001 | SF-36: Short Form-36 Health survey (range 0–100, higher score = better health) SF-6D: Single health utility index score. Part of SF-36 (range 0.29–1.00, higher score = higher function) 15D: Finish QoL questionnaire (higher score = better health, range 0–1) | ?/ +  | ? |  +  |
Andrade 2018 Brazil [42] | Non-randomized controlled study | 100 I: 50 C: 50 | NR | Breast-Q Median (range) Satisfaction with breasts: 70 (30–100) Psychosocial well-being: 92 (0–100) Sexual well-being: 88 (21–100) Physical well-being: 79 (48–100) | Breast-Q Median (range) Satisfaction with breasts: 23 (0–50) p = 0.001 Psychosocial well-being: 33 (0–71) p = 0.001 Sexual well-being: 29 (0–78) p = 0.001 Physical well-being: 48 (0–83) p = 0.001 | Breast-Q: Total scores ranging from 0–100. Higher score indicates greater satisfaction or better quality of life |  +  | − | ?/ +  |
Hermans 2005 Netherlands [43] | Non-randomized controlled study | 165 I: 94 C: 71 | 10 I: 10 C: 0 | SF-36 Physical function: 84.76 Pain: 77.65 Vitality: 67.01 Social activities: 83.69 Emotional status: 80.95 Mental health: 75.22 Physical activities: 76.19 Health perceptions: 72.26 EQ-5D Pain: No problems: 51.2% Some problems: 44.0% Many problems: 4.8% Daily activities: No problems: 72.3% Some problems: 25.3% Many problems: 2.4% | SF-36 Physical function: 77.46, p < 0.05 Pain: 57.00, p < 0.001 Vitality: 56.83, p < 0.01 Social activities: 68.30, p < 0.001 Emotional status: 64.32, p < 0.01 Mental health: 66.42, p < 0.01 Physical activities: 65.85, p = NR Health perceptions: 65.42, p < 0.05 EQ-5D Pain: No problems: 14.1%, p < 0.001 Some problems: 78.9% Many problems: 7.0% Daily activities: No problems: 46.5%, p < 0.005 Some problems: 50.7% Many problems: 2.8% | SF-36: Short Form-36 Health survey (higher score = better health, range 0–100) EQ-5D: The European Quality of Life-5 Dimensions (mobility, self-care, usual activities, pain/discomfort, anxiety/depression). 3 answers possible within each dimension. Only 2 dimensions stated in article | ? | ?/− | ? |