Normative BREAST-Q Scores in Sub-Saharan African Women: Interpreting the Impact of Mastectomy and Reconstruction.

Abstract

Background: Breast cancer is a leading cause of mortality among women in sub-Saharan Africa (SSA). As such, optimizing outcomes for treatment and reconstruction is a global health priority. Currently, normative data for interpreting BREAST-Q results are limited to high-income countries. This study seeks to evaluate baseline breast-related quality of life in SSA women without breast cancer and compare it with previously published normative values.

Methods: Women in Ghana, Nigeria, and Ethiopia 18 years of age and older with no history of breast cancer or breast surgery were recruited to complete the BREAST-Q preoperative mastectomy module. Multivariable regression was performed to identify correlations between sociodemographic variables and BREAST-Q scores. Comparisons were made between normative data previously published in high-income countries and within individual SSA populations.

Results: Normative BREAST-Q scores were obtained from a total of 453 women (169 Ghanaian, 210 Nigerian, and 74 Ethiopian) with a mean age of 26 ± 7 years and body mass index of 26 ± 6 kg/m². Scores were as follows: satisfaction with breasts, 64 ± 26; psychosocial well-being, 63 ± 23; sexual well-being, 57 ± 26; and physical well-being, 68 ± 16. Compared with scores published in the United States, SSA women scored higher in breast satisfaction and lower in psychosocial and physical well-being. Significant differences in scores were also found among countries in SSA.

Conclusions: This study establishes normative values for the BREAST-Q mastectomy module in a group of women in SSA without breast cancer and found significant variability globally and among countries within the same region.