The PRoBe-SH: A Close-Coded Patient-Reported Survey tool to Assess Breast Surgery History

Background: Diagnosis and treatment of breast cancer often involves several surgical procedures. Women with breast cancer are asked repeatedly to report their breast surgery history, often elicited in an open-ended format and relying on patient recall. Electronic medical records (EMR) and other medical documentation are not always readily available. No comprehensive, validated patient-reported measure of breast surgery history exists. We developed a close-coded, digital survey tool to elicit patient-reported breast surgery history (PRoBe-SH). Methods: We administered the PRoBe-SH survey tool to a convenience sample of patients with a history of breast cancer. We compared PRoBe-SH data to both surgical history documented in patients’ EMR and open-ended surgical history ascertained from patient-completed clinic intake forms. Sensitivity/specificity analyses and McNemar’s tests were performed. Results: Data from fifty patients (median age ۵۳.۵ years, range ۳۱-۷۱, ۷۰% non- Hispanic white) were analyzed. The sensitivity of the PRoBe-SH for accurately identifying surgical history was ۱۰۰% for mastectomy, lumpectomy ۹۶%, mastectomy sidedness ۱۰۰% (right) and ۱۰۰% (left), lumpectomy sidedness ۳۶% (right) ۵۵% (left), lymphadenectomy ۶۴%, breast reconstruction ۸۹%, and presence of a native nipple ۱۰۰% (right) and ۱۰۰% (left). Open-ended surgical history was more than ۹۰% sensitive for identifying mastectomy and lumpectomy only. The PRoBe-SH was significantly more sensitive than open-ended surgical history for identifying mastectomy sidedness (P<۰.۰۱), lymphadenectomy (P<۰.۰۱), and breast reconstruction (P<۰.۰۱). Conclusion: Ascertaining accurate breast surgical history is important in the context of clinical care and for research purposes. The PRoBe-SH is a comprehensive, highly sensitive alternative to obtaining an open-ended breast surgical history when EMR data or other medical documentation are not available.

Keywords:

Breast surgical history , Breast cancer , Patientreported measure , Selfreport tool