Validation of the Turkish Version of the Breast Reduction Assessed Severity Scale

Background: Measuring patient-reported outcomes has become increasingly important in cosmetic and reconstructive breast surgery. There is no validated questionnaire in Turkish to evaluate quality-of-life issues for patients with mammary hypertrophy. Objectives: The authors describe the reliability and validity of a translated Breast Reduction Assessed Severity Scale (BRASS) in evaluating Turkish patients. Methods: The BRASS, developed by Sigurdson et al, was translated into Turkish adhering strictly to the guidelines of questionnaire translations. Statistical analysis was carried out with Cronbach's alpha to test the internal consistency and intraclass correlation coefficient for test-retest reliability. Exploratory factor analysis was carried out using principal component analysis with oblimin rotation to test its construct validity. Correlations between subscales identified in the factor analysis and corresponding domains in the Short Form-36 and Rosenberg Self-Esteem Scale were analyzed. Results: The total instrument was found to have an alpha coefficient of 0.92 and subscale alpha coefficients ranging from 0.76 to 0.87. Intraclass correlation coefficient was 0.93 for the total scale and ranged from 0.81 to 0.91 for the subscales. Exploratory factor analysis resulted in a 5-factor structure: physical implications, body pain, physical appearance, poor self-concept, and negative social interactions. Conclusions: With this study, the reliability and validity of the Turkish version of the BRASS were revealed. This translated version can be used to evaluate the effect of mammary hypertrophy on quality of life in Turkish patients.