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Is Preoperative Happiness Influencing BREAST-Q Outcomes?
Christian X. Lava, M.S.1, Daisy L. Spoer, M.S.1, John Corbett, M.D., Ph.D.2, Lauren E. Berger, B.A.3, Karen R. Li, B.B.A.1, Parhom N. Towfighi, M.D.1, Niloofar Ghyasi, M.S.1, David H. Song, M.D.4, Kenneth L. Fan, M.D.4;
1Georgetown University School of Medicine, Washington, DC, USA, 2George Washington University, Washington, DC, USA, 3Rutgers Robert Wood Johnson Medical School, Washington, DC, USA, 4MedStar Georgetown University Hospital, Washington, DC, USA

PURPOSE: There is a lack of research on psychosocial factors that impact BREAST-Q scores. This study aims to test the following hypotheses: 1) positive affect is associated with higher breast satisfaction and psychosocial well-being and 2) socioeconomic status (SES) impacts this relationship.
METHODS: A prospective survey study and retrospective chart review of adult patients undergoing breast reconstruction between August 2020 to October 2022 was conducted. Cantril Ladder of Happiness (CLH) was used to assess current happiness (≤5: unhappy, ≥6: happy). BREAST-Q was sent preoperatively and 1-, 3-, 6-, and 12-months postoperatively. Patient characteristics, oncologic treatments, perioperative details, and outcomes were collected.
RESULTS: 75 patients completed BREAST-Q. 49 (65.3%) and 26 (34.8%) identified as “happy” and "unhappy”, respectively. Mean age was 52.3±12.0 years. “Happy” patients reported higher satisfaction with their breasts at baseline (53.7±23.9 vs. 40.±40.1, p=0.029) and three months (61.1±20.1 vs. 47.8±8.5, p=0.003); higher psychosocial well-being at baseline (69.8±17.3 vs. 52.8±18.8, p<0.001) and three months (73.8±20.5 vs. 60.4±18.8, p=0.047); higher sexual well-being at three months (57.5±28.0 vs. 33.4±17.7, p=0.007) and one year (63.1±24.0 vs. 34.6±21.8, p=0.043); and overall satisfaction at three months (85.6±11.6 vs. 72.5±11.0, p=0.002). Patients with higher CLH scores reported higher psychosocial (p<0.001) and sexual well-being (p<0.0001). Patients with higher education (p=0.019) and income (p=0.039) levels reported higher well-being of the chest.
CONCLUSION: “Happy” patients demonstrated higher satisfaction levels and improved psychosocial and sexual well-being compared to "unhappy" patients. SES played a role in patient satisfaction and overall well-being.
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