International validation of the European Organisation for Research and Treatment of Cancer QLQ-BRECON23 quality-of-life questionnaire for women undergoing breast reconstruction.
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Auteurs : Z E Winters [Royaume-Uni] ; M. Afzal [Royaume-Uni] ; C. Rutherford [Australie] ; B. Holzner [Autriche] ; G. Rumpold [Autriche] ; R A Da Costa Vieira [Brésil] ; S. Hartup [Royaume-Uni] ; K. Flitcroft [Australie] ; V. Bjelic-Radisic [Autriche] ; A. Oberguggenburger [Autriche] ; M. Panouilleres [France] ; M. Mani [Suède] ; G. Catanuto [Italie] ; M. Douek [Royaume-Uni] ; J. Kokan [Royaume-Uni] ; P. Sinai [Royaume-Uni] ; M T King [Australie]Source :
- The British journal of surgery [ 1365-2168 ] ; 2017.
Abstract
The aim was to carry out phase 4 international field-testing of the European Organisation for Research and Treatment of Cancer (EORTC) breast reconstruction (BRECON) module. The primary objective was finalization of its scale structure. Secondary objectives were evaluation of its reliability, validity, responsiveness, acceptability and interpretability in patients with breast cancer undergoing mastectomy and reconstruction.
DOI: 10.1002/bjs.10656
PubMed: 29116657
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">International validation of the European Organisation for Research and Treatment of Cancer QLQ-BRECON23 quality-of-life questionnaire for women undergoing breast reconstruction.</title><author><name sortKey="Winters, Z E" sort="Winters, Z E" uniqKey="Winters Z" first="Z E" last="Winters">Z E Winters</name><affiliation wicri:level="1"><nlm:affiliation>Breast Cancer Surgery Patient-Reported and Clinical Outcomes Research Group, University of Bristol, School of Clinical Sciences, Southmead Hospital, Bristol, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Breast Cancer Surgery Patient-Reported and Clinical Outcomes Research Group, University of Bristol, School of Clinical Sciences, Southmead Hospital, Bristol</wicri:regionArea></affiliation></author><author><name sortKey="Afzal, M" sort="Afzal, M" uniqKey="Afzal M" first="M" last="Afzal">M. 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Bjelic-Radisic</name><affiliation wicri:level="1"><nlm:affiliation>Department of Breast Surgery and Gynaecology, Medical University Graz, Graz, Austria.</nlm:affiliation><country xml:lang="fr">Autriche</country><wicri:regionArea>Department of Breast Surgery and Gynaecology, Medical University Graz, Graz</wicri:regionArea></affiliation></author><author><name sortKey="Oberguggenburger, A" sort="Oberguggenburger, A" uniqKey="Oberguggenburger A" first="A" last="Oberguggenburger">A. Oberguggenburger</name><affiliation wicri:level="1"><nlm:affiliation>Department of Psychiatry, Psychotherapy and Psychosomatics, Medical University of Innsbruck, Innsbruck, Austria.</nlm:affiliation><country xml:lang="fr">Autriche</country><wicri:regionArea>Department of Psychiatry, Psychotherapy and Psychosomatics, Medical University of Innsbruck, Innsbruck</wicri:regionArea></affiliation></author><author><name sortKey="Panouilleres, M" sort="Panouilleres, M" uniqKey="Panouilleres M" first="M" last="Panouilleres">M. Panouilleres</name><affiliation wicri:level="1"><nlm:affiliation>Department of Plastic Surgery, Besançon University Hospital, Besançon, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Department of Plastic Surgery, Besançon University Hospital, Besançon</wicri:regionArea></affiliation></author><author><name sortKey="Mani, M" sort="Mani, M" uniqKey="Mani M" first="M" last="Mani">M. Mani</name><affiliation wicri:level="1"><nlm:affiliation>Department of Surgical Sciences, Plastic and Reconstructive Surgery, Uppsala University, Uppsala, Sweden.</nlm:affiliation><country xml:lang="fr">Suède</country><wicri:regionArea>Department of Surgical Sciences, Plastic and Reconstructive Surgery, Uppsala University, Uppsala</wicri:regionArea></affiliation></author><author><name sortKey="Catanuto, G" sort="Catanuto, G" uniqKey="Catanuto G" first="G" last="Catanuto">G. Catanuto</name><affiliation wicri:level="1"><nlm:affiliation>Multidisciplinary Breast Care, Cannizzaro Hospital, Catania, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Multidisciplinary Breast Care, Cannizzaro Hospital, Catania</wicri:regionArea></affiliation></author><author><name sortKey="Douek, M" sort="Douek, M" uniqKey="Douek M" first="M" last="Douek">M. Douek</name><affiliation wicri:level="1"><nlm:affiliation>Department of Surgical Oncology, Guy's Hospital, London, London, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Department of Surgical Oncology, Guy's Hospital, London, London</wicri:regionArea></affiliation></author><author><name sortKey="Kokan, J" sort="Kokan, J" uniqKey="Kokan J" first="J" last="Kokan">J. Kokan</name><affiliation wicri:level="1"><nlm:affiliation>Cancer Resource Centre, Macclesfield Hospital, Macclesfield, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Cancer Resource Centre, Macclesfield Hospital, Macclesfield</wicri:regionArea></affiliation></author><author><name sortKey="Sinai, P" sort="Sinai, P" uniqKey="Sinai P" first="P" last="Sinai">P. Sinai</name><affiliation wicri:level="1"><nlm:affiliation>Breast Cancer Surgery Patient-Reported and Clinical Outcomes Research Group, University of Bristol, School of Clinical Sciences, Southmead Hospital, Bristol, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Breast Cancer Surgery Patient-Reported and Clinical Outcomes Research Group, University of Bristol, School of Clinical Sciences, Southmead Hospital, Bristol</wicri:regionArea></affiliation></author><author><name sortKey="King, M T" sort="King, M T" uniqKey="King M" first="M T" last="King">M T King</name><affiliation wicri:level="1"><nlm:affiliation>Quality of Life Office, School of Psychology, Faculty of Science, University of Sydney, New South Wales, Australia.</nlm:affiliation><country xml:lang="fr">Australie</country><wicri:regionArea>Quality of Life Office, School of Psychology, Faculty of Science, University of Sydney, New South Wales</wicri:regionArea></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2017">2017</date><idno type="RBID">pubmed:29116657</idno><idno type="pmid">29116657</idno><idno type="doi">10.1002/bjs.10656</idno><idno type="wicri:Area/PubMed/Corpus">000027</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Corpus" wicri:corpus="PubMed">000027</idno><idno type="wicri:Area/PubMed/Curation">000027</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Curation">000027</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">International validation of the European Organisation for Research and Treatment of Cancer QLQ-BRECON23 quality-of-life questionnaire for women undergoing breast reconstruction.</title><author><name sortKey="Winters, Z E" sort="Winters, Z E" uniqKey="Winters Z" first="Z E" last="Winters">Z E Winters</name><affiliation wicri:level="1"><nlm:affiliation>Breast Cancer Surgery Patient-Reported and Clinical Outcomes Research Group, University of Bristol, School of Clinical Sciences, Southmead Hospital, Bristol, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Breast Cancer Surgery Patient-Reported and Clinical Outcomes Research Group, University of Bristol, School of Clinical Sciences, Southmead Hospital, Bristol</wicri:regionArea></affiliation></author><author><name sortKey="Afzal, M" sort="Afzal, M" uniqKey="Afzal M" first="M" last="Afzal">M. Afzal</name><affiliation wicri:level="1"><nlm:affiliation>Breast Cancer Surgery Patient-Reported and Clinical Outcomes Research Group, University of Bristol, School of Clinical Sciences, Southmead Hospital, Bristol, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Breast Cancer Surgery Patient-Reported and Clinical Outcomes Research Group, University of Bristol, School of Clinical Sciences, Southmead Hospital, Bristol</wicri:regionArea></affiliation></author><author><name sortKey="Rutherford, C" sort="Rutherford, C" uniqKey="Rutherford C" first="C" last="Rutherford">C. Rutherford</name><affiliation wicri:level="1"><nlm:affiliation>Quality of Life Office, School of Psychology, Faculty of Science, University of Sydney, New South Wales, Australia.</nlm:affiliation><country xml:lang="fr">Australie</country><wicri:regionArea>Quality of Life Office, School of Psychology, Faculty of Science, University of Sydney, New South Wales</wicri:regionArea></affiliation></author><author><name sortKey="Holzner, B" sort="Holzner, B" uniqKey="Holzner B" first="B" last="Holzner">B. Holzner</name><affiliation wicri:level="1"><nlm:affiliation>Department of Psychiatry, Psychotherapy and Psychosomatics, Medical University of Innsbruck, Innsbruck, Austria.</nlm:affiliation><country xml:lang="fr">Autriche</country><wicri:regionArea>Department of Psychiatry, Psychotherapy and Psychosomatics, Medical University of Innsbruck, Innsbruck</wicri:regionArea></affiliation></author><author><name sortKey="Rumpold, G" sort="Rumpold, G" uniqKey="Rumpold G" first="G" last="Rumpold">G. Rumpold</name><affiliation wicri:level="1"><nlm:affiliation>Department of Medical Psychology, Evaluation Software Development, Rum, Austria.</nlm:affiliation><country xml:lang="fr">Autriche</country><wicri:regionArea>Department of Medical Psychology, Evaluation Software Development, Rum</wicri:regionArea></affiliation></author><author><name sortKey="Da Costa Vieira, R A" sort="Da Costa Vieira, R A" uniqKey="Da Costa Vieira R" first="R A" last="Da Costa Vieira">R A Da Costa Vieira</name><affiliation wicri:level="1"><nlm:affiliation>Department of Oncology, Barretos Cancer Hospital, Sao Paolo, Brazil.</nlm:affiliation><country xml:lang="fr">Brésil</country><wicri:regionArea>Department of Oncology, Barretos Cancer Hospital, Sao Paolo</wicri:regionArea></affiliation></author><author><name sortKey="Hartup, S" sort="Hartup, S" uniqKey="Hartup S" first="S" last="Hartup">S. Hartup</name><affiliation wicri:level="1"><nlm:affiliation>St James's University Hospital, Leeds Teaching Hospitals NHS Trust, Leeds, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>St James's University Hospital, Leeds Teaching Hospitals NHS Trust, Leeds</wicri:regionArea></affiliation></author><author><name sortKey="Flitcroft, K" sort="Flitcroft, K" uniqKey="Flitcroft K" first="K" last="Flitcroft">K. Flitcroft</name><affiliation wicri:level="1"><nlm:affiliation>Breast and Surgical Oncology, Poche Centre, University of Sydney, New South Wales, Australia.</nlm:affiliation><country xml:lang="fr">Australie</country><wicri:regionArea>Breast and Surgical Oncology, Poche Centre, University of Sydney, New South Wales</wicri:regionArea></affiliation></author><author><name sortKey="Bjelic Radisic, V" sort="Bjelic Radisic, V" uniqKey="Bjelic Radisic V" first="V" last="Bjelic-Radisic">V. Bjelic-Radisic</name><affiliation wicri:level="1"><nlm:affiliation>Department of Breast Surgery and Gynaecology, Medical University Graz, Graz, Austria.</nlm:affiliation><country xml:lang="fr">Autriche</country><wicri:regionArea>Department of Breast Surgery and Gynaecology, Medical University Graz, Graz</wicri:regionArea></affiliation></author><author><name sortKey="Oberguggenburger, A" sort="Oberguggenburger, A" uniqKey="Oberguggenburger A" first="A" last="Oberguggenburger">A. Oberguggenburger</name><affiliation wicri:level="1"><nlm:affiliation>Department of Psychiatry, Psychotherapy and Psychosomatics, Medical University of Innsbruck, Innsbruck, Austria.</nlm:affiliation><country xml:lang="fr">Autriche</country><wicri:regionArea>Department of Psychiatry, Psychotherapy and Psychosomatics, Medical University of Innsbruck, Innsbruck</wicri:regionArea></affiliation></author><author><name sortKey="Panouilleres, M" sort="Panouilleres, M" uniqKey="Panouilleres M" first="M" last="Panouilleres">M. Panouilleres</name><affiliation wicri:level="1"><nlm:affiliation>Department of Plastic Surgery, Besançon University Hospital, Besançon, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Department of Plastic Surgery, Besançon University Hospital, Besançon</wicri:regionArea></affiliation></author><author><name sortKey="Mani, M" sort="Mani, M" uniqKey="Mani M" first="M" last="Mani">M. Mani</name><affiliation wicri:level="1"><nlm:affiliation>Department of Surgical Sciences, Plastic and Reconstructive Surgery, Uppsala University, Uppsala, Sweden.</nlm:affiliation><country xml:lang="fr">Suède</country><wicri:regionArea>Department of Surgical Sciences, Plastic and Reconstructive Surgery, Uppsala University, Uppsala</wicri:regionArea></affiliation></author><author><name sortKey="Catanuto, G" sort="Catanuto, G" uniqKey="Catanuto G" first="G" last="Catanuto">G. Catanuto</name><affiliation wicri:level="1"><nlm:affiliation>Multidisciplinary Breast Care, Cannizzaro Hospital, Catania, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Multidisciplinary Breast Care, Cannizzaro Hospital, Catania</wicri:regionArea></affiliation></author><author><name sortKey="Douek, M" sort="Douek, M" uniqKey="Douek M" first="M" last="Douek">M. Douek</name><affiliation wicri:level="1"><nlm:affiliation>Department of Surgical Oncology, Guy's Hospital, London, London, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Department of Surgical Oncology, Guy's Hospital, London, London</wicri:regionArea></affiliation></author><author><name sortKey="Kokan, J" sort="Kokan, J" uniqKey="Kokan J" first="J" last="Kokan">J. Kokan</name><affiliation wicri:level="1"><nlm:affiliation>Cancer Resource Centre, Macclesfield Hospital, Macclesfield, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Cancer Resource Centre, Macclesfield Hospital, Macclesfield</wicri:regionArea></affiliation></author><author><name sortKey="Sinai, P" sort="Sinai, P" uniqKey="Sinai P" first="P" last="Sinai">P. Sinai</name><affiliation wicri:level="1"><nlm:affiliation>Breast Cancer Surgery Patient-Reported and Clinical Outcomes Research Group, University of Bristol, School of Clinical Sciences, Southmead Hospital, Bristol, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Breast Cancer Surgery Patient-Reported and Clinical Outcomes Research Group, University of Bristol, School of Clinical Sciences, Southmead Hospital, Bristol</wicri:regionArea></affiliation></author><author><name sortKey="King, M T" sort="King, M T" uniqKey="King M" first="M T" last="King">M T King</name><affiliation wicri:level="1"><nlm:affiliation>Quality of Life Office, School of Psychology, Faculty of Science, University of Sydney, New South Wales, Australia.</nlm:affiliation><country xml:lang="fr">Australie</country><wicri:regionArea>Quality of Life Office, School of Psychology, Faculty of Science, University of Sydney, New South Wales</wicri:regionArea></affiliation></author></analytic><series><title level="j">The British journal of surgery</title><idno type="eISSN">1365-2168</idno><imprint><date when="2017" type="published">2017</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">The aim was to carry out phase 4 international field-testing of the European Organisation for Research and Treatment of Cancer (EORTC) breast reconstruction (BRECON) module. The primary objective was finalization of its scale structure. Secondary objectives were evaluation of its reliability, validity, responsiveness, acceptability and interpretability in patients with breast cancer undergoing mastectomy and reconstruction.</div></front></TEI><pubmed><MedlineCitation Status="Publisher" Owner="NLM"><PMID Version="1">29116657</PMID><DateCreated><Year>2017</Year><Month>11</Month><Day>08</Day></DateCreated><DateRevised><Year>2017</Year><Month>11</Month><Day>08</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1365-2168</ISSN><JournalIssue CitedMedium="Internet"><PubDate><Year>2017</Year><Month>Nov</Month><Day>08</Day></PubDate></JournalIssue><Title>The British journal of surgery</Title><ISOAbbreviation>Br J Surg</ISOAbbreviation></Journal><ArticleTitle>International validation of the European Organisation for Research and Treatment of Cancer QLQ-BRECON23 quality-of-life questionnaire for women undergoing breast reconstruction.</ArticleTitle><ELocationID EIdType="doi" ValidYN="Y">10.1002/bjs.10656</ELocationID><Abstract><AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">The aim was to carry out phase 4 international field-testing of the European Organisation for Research and Treatment of Cancer (EORTC) breast reconstruction (BRECON) module. The primary objective was finalization of its scale structure. Secondary objectives were evaluation of its reliability, validity, responsiveness, acceptability and interpretability in patients with breast cancer undergoing mastectomy and reconstruction.</AbstractText><AbstractText Label="METHODS" NlmCategory="METHODS">The EORTC module development guidelines were followed. Patients were recruited from 28 centres in seven countries. A prospective cohort completed the QLQ-BRECON15 before mastectomy and the QLQ-BRECON24 at 4-8 months after reconstruction. The cross-sectional cohort completed the QLQ-BRECON24 at 1-5 years after reconstruction, and repeated this 2-8 weeks later (test-retest reliability). All participants completed debriefing questionnaires.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">A total of 438 patients were recruited, 234 in the prospective cohort and 204 in the cross-sectional cohort. A total of 414 reconstructions were immediate, with a comparable number of implants (176) and donor-site flaps (166). Control groups comprised patients who underwent two-stage implant procedures (72, 75 per cent) or delayed reconstruction (24, 25 per cent). Psychometric scale validity was supported by moderate to high item-own scale and item-total correlations (over 0·5). Questionnaire validity was confirmed by good scale-to-sample targeting, and computable scale scores exceeding 50 per cent, except nipple cosmesis (over 40 per cent). In known-group comparisons, QLQ-BRECON24 scales and items differentiated between patient groups defined by clinical criteria, such as type and timing of reconstruction, postmastectomy radiotherapy and surgical complications, with moderate effect sizes. Prospectively, sexuality and surgical side-effects scales showed significant responsiveness over time (P < 0·001). Scale reliability was supported by high Cronbach's α coefficients (over 0·7) and test-retest (intraclass correlation more than 0·8). One item (finding a well fitting bra) was excluded based on high floor/ceiling effects, poor test-retest and weak correlations in factor analysis (below 0·3), thus generating the QLQ-BRECON23 questionnaire.</AbstractText><AbstractText Label="CONCLUSION" NlmCategory="CONCLUSIONS">The QLQ-BRECON23 is an internationally validated tool to be used alongside the EORTC QLQ-C30 (cancer) and QLQ-BR23 (breast cancer) questionnaires for evaluating quality of life and satisfaction after breast reconstruction.</AbstractText><CopyrightInformation>© 2017 BJS Society Ltd Published by John Wiley & Sons Ltd.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Winters</LastName><ForeName>Z E</ForeName><Initials>ZE</Initials><Identifier Source="ORCID">http://orcid.org/0000-0002-3507-4515</Identifier><AffiliationInfo><Affiliation>Breast Cancer Surgery Patient-Reported and Clinical Outcomes Research Group, University of Bristol, School of Clinical Sciences, Southmead Hospital, Bristol, UK.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Surgical and Interventional Trials Unit, Division of Surgical Sciences, University College London, London, UK.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Quality of Life Office, School of Psychology, Faculty of Science, University of Sydney, New South Wales, Australia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Afzal</LastName><ForeName>M</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Breast Cancer Surgery Patient-Reported and Clinical Outcomes Research Group, University of Bristol, School of Clinical Sciences, Southmead Hospital, Bristol, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Rutherford</LastName><ForeName>C</ForeName><Initials>C</Initials><AffiliationInfo><Affiliation>Quality of Life Office, School of Psychology, Faculty of Science, University of Sydney, New South Wales, Australia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Holzner</LastName><ForeName>B</ForeName><Initials>B</Initials><AffiliationInfo><Affiliation>Department of Psychiatry, Psychotherapy and Psychosomatics, Medical University of Innsbruck, Innsbruck, Austria.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Rumpold</LastName><ForeName>G</ForeName><Initials>G</Initials><AffiliationInfo><Affiliation>Department of Medical Psychology, Evaluation Software Development, Rum, Austria.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>da Costa Vieira</LastName><ForeName>R A</ForeName><Initials>RA</Initials><AffiliationInfo><Affiliation>Department of Oncology, Barretos Cancer Hospital, Sao Paolo, Brazil.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Hartup</LastName><ForeName>S</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>St James's University Hospital, Leeds Teaching Hospitals NHS Trust, Leeds, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Flitcroft</LastName><ForeName>K</ForeName><Initials>K</Initials><Identifier Source="ORCID">http://orcid.org/0000-0003-4945-0857</Identifier><AffiliationInfo><Affiliation>Breast and Surgical Oncology, Poche Centre, University of Sydney, New South Wales, Australia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Bjelic-Radisic</LastName><ForeName>V</ForeName><Initials>V</Initials><AffiliationInfo><Affiliation>Department of Breast Surgery and Gynaecology, Medical University Graz, Graz, Austria.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Oberguggenburger</LastName><ForeName>A</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Department of Psychiatry, Psychotherapy and Psychosomatics, Medical University of Innsbruck, Innsbruck, Austria.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Panouilleres</LastName><ForeName>M</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Department of Plastic Surgery, Besançon University Hospital, Besançon, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Mani</LastName><ForeName>M</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Department of Surgical Sciences, Plastic and Reconstructive Surgery, Uppsala University, Uppsala, Sweden.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Catanuto</LastName><ForeName>G</ForeName><Initials>G</Initials><AffiliationInfo><Affiliation>Multidisciplinary Breast Care, Cannizzaro Hospital, Catania, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Douek</LastName><ForeName>M</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Department of Surgical Oncology, Guy's Hospital, London, London, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Kokan</LastName><ForeName>J</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>Cancer Resource Centre, Macclesfield Hospital, Macclesfield, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Sinai</LastName><ForeName>P</ForeName><Initials>P</Initials><AffiliationInfo><Affiliation>Breast Cancer Surgery Patient-Reported and Clinical Outcomes Research Group, University of Bristol, School of Clinical Sciences, Southmead Hospital, Bristol, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>King</LastName><ForeName>M T</ForeName><Initials>MT</Initials><AffiliationInfo><Affiliation>Quality of Life Office, School of Psychology, Faculty of Science, University of Sydney, New South Wales, Australia.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Sydney Medical School, Faculty of Medicine, University of Sydney, New South Wales, Australia.</Affiliation></AffiliationInfo></Author><Author 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