OBJECTIVES: Assessing the effects of breast reconstruction (BR) on patient-reported outcomes (PRO) is important as BR becomes increasingly common after mastectomy. A systematic literature review was conducted to assess the clinical use of a well-validated PRO instrument, the BREAST-Q (BQ) in women undergoing BR. METHODS: Searches using PubMed, ScienceDirect, Cochrane Library, and references in plastic surgery journals were conducted from when BQ was developed in 2008 to May 2014 using the term, ‘breast-q OR breastq’. Non-English, reviews, letters, protocols and single-patient case reports were excluded. BQ modules unrelated to reconstruction (e.g., Augmentation or Reduction) were also excluded. Each BQ scale score ranged from 0-100 with a higher score representing better PRO. RESULTS: After applying exclusion criteria, 35 studies were retrieved. Majority of studies were conducted in North America (54%, 19/35) or Europe (29%, 10/35). Study sample size ranged from N=14 to 7,110 with mean age ranging 46-55 years. When compared to mastectomy alone, BR was associated with higher PROs (p<0.05) however, adjuvant radiotherapy was associated with significantly lower PROs than without radiotherapy (p<0.05). Among PRO scales, sexual well-being was consistently low (range: 30-84) and the scores of physical well-being and satisfaction with surgeons were consistently high (ranges: 68-89 and ≥70, respectively). Majority of the studies administered BQ as a single administration post-BR. Only 4 studies reported the change from pre- to post-BR (Range of change score = -19 to 36). From 3 of 4 studies, the scale with the largest Cohen’s d effect size (ES) was psychosocial well-being (ES range: 1.52-3.83). CONCLUSIONS: Our findings suggest that while BQ is widely used, study type and method of administration are disparate. Further assessment of the BQ especially in comparative and longitudinal studies is recommended in order to enhance use of BQ in clinical decision making around BR modalities.