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RecruitingNCT04889469Updated Jul 3, 2025

Indications for Breast Reduction in the Public Health Care System

An observational study in Mammary Gland Hyperplasia, sponsored by Vastra Gotaland Region. Recruiting at 1 site in Sweden. Open to female participants aged 18 Years to 75 Years. Per ClinicalTrials.gov, last updated 2025-07-03.

Sponsored by Vastra Gotaland Region · Observational

Study type
Observational
Model
Case-control
Time perspective
Prospective
Enrollment
2,000
Ages
18 Years to 75 Years
Sex
Female
01

Study summary

The overall purpose of the project is to create a scientific basis for which patients should be offered breast reduction in the public sector. More specifically , the project aims to:

  • To examine the evidence for current national guidelines for breast reduction. The hypothesis is that BMI, breast volume, resection weight, and mental and physical symptoms affect the outcome of breast reconstruction, both in terms of complication risks, patient satisfaction and quality of life .
  • To investigate which patients benefit the most from a breast reduction, in a health economic perspective. The starting point is that resources are limited and the purpose is to maximize the health effects for the patient at as low cost as possible. The hypothesis is that the health benefits, for the individual and society, are different depending on how big the breasts are and how much symptoms a patient has preoperatively.
  • To examine back function and objective problems in women, with both natural and augmented breasts, with different body constitutions and volumes. The hypothesis is that a certain breast volume give rise to different physical symptoms in different women, depending on their other physical factors.
  • To develop preferences for benign breast conditions that are treated in plastic surgery and for complications that the treatment can cause. Preferences are used to calculate QALY (quality-adjusted life years). Knowledge of preferences is essential for an analysis of healthcare needs.
  • To examine women's experiences of how their breast hypertrophy affects them and their expectations of a breast reduction. The hypothesis is that the experience breast hypertrophy affects patients differently, and that expectations on a breast reduction can vary between different individuals.
02

Conditions studied

  • Mammary Gland Hyperplasia

Keywords

  • breast reduction
  • reduction mammaplasty
  • breast hypertrophy
03

Who can participate

Ages eligible
18 Years to 75 Years
Sexes eligible
Female
Accepts healthy volunteers
No
Sampling method
Non-probability sample

Study population

Normal weight women with breast volumes over >800 ml (augmented or natural) with or without symptoms of breast hypertrophy. Normal weight women with a breast volume under 800 ml with symptoms of breast hypertrophy.

Inclusion criteria

  • Breast volume > 800 ml
  • BMI\< 25 if under 50 years of age and BMI\<2 if over the age of 50
  • Symptoms of breast hypertrophy
  • Non-smokers

Un-operad controls:

-Symptoms of breast hypertrophy, but do not comply with the criteria above.

Augmented controls:

  • Augmented breast volume > 800 ml
  • BMI\< 25 if under 50 years of age and BMI\<2 if over the age of 50

Exclusion criteria

Exclusion Criteria:

  • Inability to provide informed consent
  • Inability to understand the Swedish language
  • Age under 18 years
04

Study design

Observational model
Case-control
Time perspective
Prospective
Enrollment
2,000 participants (estimated)
Target follow-up
5 Years
Patient registry
Yes

Groups and cohorts

  • Breast hypertrophy operated

    Women who have had a breast reduction in the public health care system

    Procedure: Breast reduction

  • Breast hypertrophy controls

    Women with symptoms of breast hypertrophy, who do not fulfill the requirements to have a breast reduction in the public health care system

  • Augmented controls

    Patients who have breast hypertrophy due to cosmetic breast augmentation

  • The general public

    Random sample of the general public

Interventions

  • ProcedureBreast reduction

    Procedure to remove excess fat, tissue and skin from the breasts.

05

What researchers measure

Primary outcomes

  1. Patient reported quality of life

    Breast -Q breast reduction preoperatively and postoperatively measures quality of life and patient satisfaction in 6 domains: physical well-being, psychosocial well-being, sexual well-being, satisfaction with the breasts, satisfaction with the result and satisfaction with care. Each domain is scored 0-100, where a higher score indicate a better outcome.

    Time frame: 5 years

  2. Complications

    Complications after surgery classified according to Clavien-Dindo

    Time frame: 1 year

  3. Preferences (utility)

    utility scores for various benign breast conditions that may require plastic surgery , including complications after cosmetic surgery, will be measured. Complications will be compared with situations without these , but also with congenital conditions that give a similar appearance. Measured with a visual analogue scale from 1-100.

    Time frame: 5 years

  4. Range of motion

    Measured with goniometer in degrees

    Time frame: 1 year

  5. Muscle strength

    Biering-Sörensen test measuring how many seconds the subject is able to keep the unsupported upper body horizontal, while placed prone with the buttocks and legs fixed to the couch by three wide canvas straps and the arms folded across the chest

    Time frame: 1 year

  6. Cost-effectiveness

    Analysis of costs related to quality-adjusted life years, comparing operation with no operation.

    Time frame: 1 year

Secondary outcomes

  1. Patient reported health

    EuroQol-5 dimensions - 3 levels -5D is a generic instrument developed for health economic and clinical evaluation of healthcare.A total score between 0 and 1 is calculated. = equals death and 1 perfect health.

    Time frame: 5 years

  2. Patient reported health

    EQ VAS measures health on a scale from 0-100, where 100 equals perfect health and 0 worst possible health.

    Time frame: 5 years

  3. Body image

    Multidimensional body-self relation questionnaire - appearance scales ( MBSRQ -AS).It is a 34-item self-report questionnaire designed to measure appearance related components of body-image. In consists of five subscales: appearance evaluation, appearance orientation, body areas satisfaction, overweight preoccupation, and self-classified weight. It is a 5-point Likert-scale ranging from 1 to 5.

    Time frame: 5 years

  4. Body investment

    Appearance schemes inventory-revised ( ASI -R)is a 20-item self-report questionnaire designed to measure body-image investment. It consists of two subscales, self-evaluative salience (SES) and motivational salience (MS). It is a 5-point Likert-scale ranging from 1 (strongly disagree) to 5 (strongly agree). Twelve items relate to SES and eight items relate to MS. The total score is the mean of the 20 items, and the score of the subscales is the mean of the items relating to each subscale. A high score indicates greater body-image investment.

    Time frame: 5 years

  5. Pain intensity and quality

    Short Form McGill Pain Questionnaire (SF- MPQ ).Measures pain on three subscales : a sensory subscale with 11 words, an affective subscale with 4 words that measures the quality of pain and a visual analogue scale (VAS) where the patient rates pain intensity from 1 to 10.

    Time frame: 5 years

  6. Pain intensity and effect on every-day life

    Brief Pain Inventory -Short Form ( BPI -SF).Measures both pain intensity (sensory scale) and how pain affects the patient's life ( activity scale). The instrument also contains questions about pain relief, pain quality and the patient's experience of the cause of pain.The BPI scale defines pain as follows: Worst Pain Score: 1 - 4 = Mild Pain. Worst Pain Score: 5 - 6 = Moderate Pain. Worst Pain Score: 7 - 10 = Severe Pain.

    Time frame: 5 years

  7. Most important reason for operation

    In-house designed questionnaire where patients preoperatively rank the most important reasons why they want to be operated on.

    Time frame: Pre-operative

  8. Most important effects of an operation

    In-house designed questionnaire where patients postoperatively rank what the most important effects of the operation are.

    Time frame: 1 year

  9. The experience of breast hypertrophy and a breast reduction

    The issues will be examined mainly with the help of semi-structured qualitative in-depth interviews.

    Time frame: 1 year

06

Study locations

1 of 1 sites recruiting
  • Sahlgrenska university hospital
    Gothenburg, 413 45, Sweden
    Recruiting
07

References and documents

Publications

  • Widmark-Jensen E, Bernhardsson S, Eriksson M, Hallberg H, Jepsen C, Jivegard L, Liljegren A, Petzold M, Svensson M, Warnberg F, Hansson E. A systematic review and meta-analysis of risks and benefits with breast reduction in the public healthcare system: priorities for further research. BMC Surg. 2021 Sep 11;21(1):343. doi: 10.1186/s12893-021-01336-7. PubMed 34511096 ↗

Individual participant data

Plan to share: No

08

Registry details

Key details

Study ID
NCT04889469
Lead sponsor
Vastra Gotaland Region
Responsible party
Sponsor
First posted
May 17, 2021
Start date
Aug 1, 2021
Primary completion
Aug 1, 2028 (estimated)
Completion
Aug 1, 2031 (estimated)
Last update
Jul 3, 2025

Study contacts

Emma Hansson, PhD
Contact
emma.hansson.2@gu.se
+46313421000
Emma Hansson, PhD
principal investigator · Göteborg University

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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