Clinical outcomes in reduction mammaplasty: A systematic review and meta-analysis of published studies

This systematic review and meta-analysis were undertaken to determine wheth er reduction mammaplasty improves measurable outcomes in women with breast hypertrophy. A systematic review of the literature in 5 languages from 1985 until March 1999 was performed, and data were compared for meta-analysis. Eligible studies were both experimental and observational and involved wome n with preoperative physical and/or psychosocial signs and symptoms who und erwent reduction mammaplasty for breast hypertrophy. Outcomes assessed were postoperative physical signs and symptoms such as shoulder pain, shoulder (bra strap) grooving, and quality-of-life domains, such as physical and psy chological functioning, and were expressed primarily as risk differences (R Ds). Twenty-nine studies of 4173 patients met all eligibility criteria. Red uction mammaplasty was associated with a statistically significant improvem ent in physical signs and symptoms involving shoulder pain (RD, 0.71 [95% c onfidence interval (CI), 0.62-0.80]); shoulder grooving (RD, 0.69 [95% CI, 0.60-0.78]); upper/lower back pain (RD, 0.59 [95% CI, 0.48-0.70]); neck pai n (RD, 0.50 [95% CI, 0.37-0.64]); intertrigo (RD, 0.44 [95% CI, 0.34-0.54]) ; breast pain (RD, 0.36 [95% CI, 0.17-0.55]); headache (RD, 0.28 [95% CI, 0 .11-0.46]); and pain/numbness in the hands (RD, 0.11 [95% CI, 0.04-0.1.8]). The quality-of-life parameter of physical functioning was also statistical ly significant (RD, 0.58 [95% CI, 0.44-0.71]), while psychological function ing was not significant (RD, 0.46 [95% CI, 0.00-1.00]). The evidence sugges ts that women undergoing reduction mammaplasty for breast hypertrophy have significant postoperative improvement in preoperative signs and symptoms, q uality of life, or both.