The PRoBe-SH: A Close-Coded Patient-Reported Survey tool to Assess Breast Surgery History abstract
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 53.5 years, range 31-71, 70% non-
Hispanic white) were analyzed. The sensitivity of the PRoBe-SH for accurately
identifying surgical history was 100% for mastectomy, lumpectomy 96%,
mastectomy sidedness 100% (right) and 100% (left), lumpectomy sidedness 36%
(right) 55% (left), lymphadenectomy 64%, breast reconstruction 89%, and presence
of a native nipple 100% (right) and 100% (left). Open-ended surgical history was
more than 90% sensitive for identifying mastectomy and lumpectomy only. The
PRoBe-SH was significantly more sensitive than open-ended surgical history for
identifying mastectomy sidedness (P<0.01), lymphadenectomy (P<0.01), and breast
reconstruction (P<0.01).
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.