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Should breast reduction surgery be rationed? A comparison of the health status of patients before and after treatment: postal questionnaire survey

BMJ 1996; 313 doi: https://doi.org/10.1136/bmj.313.7055.454 (Published 24 August 1996) Cite this as: BMJ 1996;313:454
  1. Anne Klassen, research officera,
  2. Ray Fitzpatrick, professor of public health and primary careb,
  3. Crispin Jenkinson, deputy directora,
  4. Tim Goodacre, consultant plastic surgeonc
  1. a Health Services Research Unit, Department of Public Health and Primary Care, University of Oxford, Radcliffe Infirmary, Oxford OX2 6HE
  2. b Department of Public Health and Primary Care, University of Oxford
  3. c Department of Plastic and Reconstructive Surgery, Radcliffe Infirmary, Oxford OX2 6HE
  1. Correspondence to: Professor Fitzpatrick.
  • Accepted 11 June 1996

Abstract

Objectives: To assess the health status of patients before and after breast reduction surgery and to make comparisons with the health status of women in the general population.

Design: Postal questionnaire survey sent to patients before and six months after surgery.

Setting: The three plastic surgery departments in the Oxford Regional Health Authority, during April to August 1993.

Subjects: 166 women (over the age of 16 years) referred for breast reduction; scores from the “short form 36” (SF-36) health questionnaire completed by women in the 1991-2 Oxford healthy life survey.

Main outcome measures: Health status of breast reduction patients before and after surgery as assessed by the SF-36, the 28 item general health questionnaire, and Rosenberg's self esteem scale; comparisons between the health status of breast reduction patients and that of women in the general population; outcome of surgery as assessed retrospectively by patients.

Results: Differences between the health status of breast reduction patients and that of women in the general population were detected by the SF-36 both before and after surgery. Breast reduction surgery produced substantial change in patients' physical, social, and psychological function. The proportion of cases of possible psychiatric morbidity according to the general health questionnaire fell from 41% (22/54) before surgery to 11% (6/54) six months after treatment. Eighty six per cent (50/58) of patients expressed great satisfaction with the surgical result postoperatively.

Conclusion: The study provides empirical evidence that supports the inclusion of breast reduction surgery in NHS purchasing contracts.

Footnotes

  • Funding Anglia and Oxford Regional Health Authority.

  • Conflict of interest None.

  • Accepted 11 June 1996
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