Table 6 Physical function
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* |
|---|---|---|---|---|---|---|---|---|---|
Freire 2007 Brazil [37] | RCT | 100 I: 50 C: 50 | 8 I: 4 C: 4 | HAQ-20 Pre-op: 0.44 (0.38) 6 months post-op: 0.12 (0.23) | HAQ-20 Baseline: 0.48 (0.40) 6 months after baseline: 0.46 (0.30) p < 0.001 MD 0.34 | HAQ-20 has 8 dimensions that evaluate aspects of daily life: dress, get up without support, feed yourself, walk on the flat, take a shower, reach objects, grasp objects, domestic tasks. It gives a summary score between 0 (able) to 3 (disabled) |  +  | ?/− | ? |
Neto 2008 Brazil [36] | RCT (same as above) | 100 I: 50 C: 50 | 8 I: 4 C: 4 | Roland-Morris questionnaire Pre-op: 5.9 (4.9) 6 months post-op: 1.2 (1.9) Intragroup difference, p < 0.001 | Roland-Morris questionnaire Baseline: 6.2 (4.8) 6 months after baseline: 6.2 (3.9) Intragroup difference, N.S MD 0.5 (p < 0.001) | Roland-Morris questionnaire measures functional capacity and is scored from 0 (best performance) to 24 (worst performance) Intergroup difference NR |  +  | − | − |
Saariniemi 2008 Finland [34] | RCT | 82 I: 40 C: 42 | 8 I: 11 C: 7 | SF-36 physical summary score Pre-op: 42 (8.6) 6 months post-op: 51.7 (SD NR) | SF-36 physical summary score Baseline: 42.6 (8.9) 6 months after baseline: 43.3 (SD NR) MD 8.4 (95% CI 5.8 to 11.8), p < 0.0001 | The SF-36 physical summary score represents a norm-based scoring with a mean value of 50 and a SD of 10 (range 0–100). The higher the score, the greater the satisfaction. No MID is established | ?/ +  | ? |  +  |
Andrade 2018 Brazil [42] | Non-randomized controlled study | 100 I: 50 C: 50 | 0 | Breast Q physical well-being Post-op median: 79 (48–100) | Breast Q physical well-being pre-op median: 48 (0–83) p = 0.001 | Total scores for the subscale physical well-being range from 0 to 100. The higher the score, the greater the satisfaction. There are no MID for subscales |  +  | − | ?/ +  |
Hermans 2005 The Netherlands [43] | Non-randomized controlled study | 165 I: 94 C: 71 | 10 I: 10 C: 0 | SF-36 physical function Postop mean value after 12–24 months: 84.76 | SF-36 physical function Before surgery 77.46 p < 0.05 | SF-36 is scored 0–100 where a higher score indicates better health status. MID not possible to establish | ? | ?/− | ? |
|  |  |  |  | EQ 5D-daily activities Postop mean after 12–24 months: No problems 72.3 Some problems 25.3 Many problems 2.4 | EQ 5D-daily activities Before surgery No problems 46.5 Some problems 50.7 Many problems 2.8 p < 0.005 |  |  |  |  |
|  |  |  |  | DAS-59 I have physical disabilities because of my features 12–24 months postoperatively: Almost never 89% Sometimes 6% Always often 5% | DAS-59 I have physical disabilities because of my features Almost never 6% Sometimes 23% Always often 72% p = NS |  |  |  |  |