Breast Cancer and Reconstruction: Normative Data for Interpreting the BREAST-Q.

difference between the Reduction and Reconstruction modules, particularly since it exceeds the mean minimal important difference reported to be 7 to 10.4 Notably, this difference may indicate mastectomy and breast-conserving therapy patients who have historically been evaluated using the Reconstruction module1 and now would be evaluated using the Mastectomy and Breast Conserving Therapy modules may not have comparable data for the Physical Well-being Chest domain. In addition, we appreciate the authors’ discussion of the demographics of their normative values cohort. In this study, 92 percent of women were white non-Hispanic, 84 percent had a college degree or above (with 39 percent holding a master’s or doctoral degree), and 44 percent cited an annual gross household income greater than $100,000. Although we view this population as an improvement over the previous sample reported,5 we feel strongly that a more diverse normative population would further elucidate differences between normative values and those of breast surgery patients, particularly because certain socioeconomic factors such as education, income, and employment status have been correlated with differences in BREAST-Q scores. This differs somewhat from the authors’ findings that age, income, body mass index, and bra cup size influence differences in scores in the Army of Women population. Nevertheless, we appreciate this excellent work and how it is advancing the study of quality of life and satisfaction in breast surgery patients. We look forward to the authors’ response. DOI: 10.1097/PRS.0000000000003970