Comparing BREAST-Q Scores by Race Among Patients Who Underwent Breast Reconstruction: A Global Systematic Review and Meta-Analysis.
5 affiliations
- 1Faculty of Medicine, University of Ottawa, Ottawa, Canada.
- 2Faculty of Medicine, University of Toronto, Toronto, Canada.
- 3Division of Plastic, Reconstructive and Aesthetic Surgery, University of Toronto, Toronto, Canada.
- 4Division of Plastic Surgery, Department of Surgery, University of British Columbia, Vancouver, Canada.
- 5Division of Plastic Surgery, Department of Surgery, University of Ottawa, Ottawa, Canada.
Abstract
Background
Breast reconstruction (BR) is an important component of comprehensive breast cancer care. Racial minorities often face barriers to BR access and worse clinical outcomes versus White counterparts. We sought to (1) compare BREAST-Q scores by race among BR patients at least one year post-reconstruction; (2) synthesize mean BREAST-Q scores by race; and (3) summarize reconstruction characteristics.Methods
In this systematic review and meta-analysis, MEDLINE, Embase, Web of Science, and CENTRAL were searched from inception to August 13, 2025 for studies comparing postoperative BREAST-Q outcomes by race globally. Risk of bias was assessed using ROBINS-E. Primary outcomes were the literature-pooled mean differences (MD) in satisfaction with breasts, and psychosocial, sexual, and physical (chest) well-being domains among White versus non-White patients, evaluated with a random-effects meta-analysis. We secondarily pooled mean BREAST-Q outcomes by race and described reconstruction characteristics.Results
Eleven studies were included, encompassing 8108 White, 702 Black, 1037 Asian, 0 American Indian or Alaska Native, and 0 Native Hawaiian/Pacific Islander BR patients. White patients reported significantly higher satisfaction with breast scores compared to Black patients (MD = 5.25; 95% CI [2.90, 7.59]; I² = 0%; p < .0001), exceeding the minimal important difference. No significant difference was found in BREAST-Q scores of White and Black patients for psychosocial, sexual, and physical (chest) well-being.Conclusion
White patients reported higher postoperative breast satisfaction than Black patients. Future research should use standardized, race-specific BREAST-Q reporting, while validating the measure across diverse populations to clarify and address structural causes of satisfaction disparities.
Related
- Comparing a Dedicated Breast Spectral CT Protocol With Standard MonoE40 Reconstruction for Breast Cancer Characterization and Opportunistic Assessment
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- Long-term oncological outcomes after nipple-sparing mastectomy and implant-based immediate breast reconstruction in a population-based cohort of breast cancer patients
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- Adjunctive Treatments Reduce Ischemia-Reperfusion Injury in Breast Reconstruction After Mastectomy: A Systematic Review
BibTeX
@article{mah2026comparing,
title = {{Comparing BREAST-Q Scores by Race Among Patients Who Underwent Breast Reconstruction: A Global Systematic Review and Meta-Analysis.}},
author = {Alexis E Mah and Parsa Razeghi and Shaishav Datta and Brandon Chai and Jacob Hardy and Laura Snell},
journal = {Plastic surgery (Oakville, Ont.)},
year = {2026},
month = oct,
doi = {10.1177/22925503261500109},
url = {https://europepmc.org/article/MED/42968900},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - Comparing BREAST-Q Scores by Race Among Patients Who Underwent Breast Reconstruction: A Global Systematic Review and Meta-Analysis.
AU - Alexis E Mah
AU - Parsa Razeghi
AU - Shaishav Datta
AU - Brandon Chai
AU - Jacob Hardy
AU - Laura Snell
PY - 2026
DA - 2026/10/30
JO - Plastic surgery (Oakville, Ont.)
DO - 10.1177/22925503261500109
UR - https://europepmc.org/article/MED/42968900
AB - Background Breast reconstruction (BR) is an important component of comprehensive breast cancer care. Racial minorities often face barriers to BR access and worse clinical outcomes versus White counterparts. We sought to (1) compare BREAST-Q scores by race among BR patients at least one year post-reconstruction; (2) synthesize mean BREAST-Q scores by race; and (3) summarize reconstruction characteristics.Methods In this systematic review and meta-analysis, MEDLINE, Embase, Web of Science, and CENTRAL were searched from inception to August 13, 2025 for studies comparing postoperative BREAST-Q outcomes by race globally. Risk of bias was assessed using ROBINS-E. Primary outcomes were the literature-pooled mean differences (MD) in satisfaction with breasts, and psychosocial, sexual, and physical (chest) well-being domains among White versus non-White patients, evaluated with a random-effects meta-analysis. We secondarily pooled mean BREAST-Q outcomes by race and described reconstruction characteristics.Results Eleven studies were included, encompassing 8108 White, 702 Black, 1037 Asian, 0 American Indian or Alaska Native, and 0 Native Hawaiian/Pacific Islander BR patients. White patients reported significantly higher satisfaction with breast scores compared to Black patients (MD = 5.25; 95% CI [2.90, 7.59]; I² = 0%; p < .0001), exceeding the minimal important difference. No significant difference was found in BREAST-Q scores of White and Black patients for psychosocial, sexual, and physical (chest) well-being.Conclusion White patients reported higher postoperative breast satisfaction than Black patients. Future research should use standardized, race-specific BREAST-Q reporting, while validating the measure across diverse populations to clarify and address structural causes of satisfaction disparities.
SN - 2292-5503
SN - 2292-5511
ER -