Comparison of Quality of Life Based on Surgical Technique in Patients with Breast Cancer

Abstract

Objective: More than 80% of women with breast cancer survive for more than 5 years; quality of life is an important issue in these patients. The aim of this study was to assess differences in quality of life among patients who have undergone breast-conserving surgery, total mastectomy and immediate reconstruction after total mastectomy. Methods: A cross-sectional study was conducted during follow-up visits. Women who underwent surgical treatment at least 2 years prior were eligible if they were aged 20 -70 years and had a diagnosis of breast cancer (Stages 0 -III). Quality of life was evaluated based on the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire breast cancer-specific module, Rosenberg Self-esteem Scale, Beck Depression Index, Body Image Scale and sexual scale of the Cancer Rehabilitation Evaluation System. Results: A total of 407 patients completed the questionnaires; 254 were treated with breast-conserving surgery, 122 with total mastectomy and 31 with reconstruction after total mastectomy. The mean period between surgery and the survey was 49 months. Women in the breast-conserving surgery group showed better outcomes than women in the total mastectomy and reconstruction after total mastectomy groups with respect to emotional -social function, nausea/vomiting, financial difficulty, body image, arm symptoms and self-esteem. Patients in the reconstruction after total mastectomy group had significantly better outcomes on the sexual scale of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire breast cancer-specific module and arm symptoms than the total mastectomy group. Conclusions: Quality of life was better in the breast-conserving surgery group than in the total mastectomy or reconstruction after total mastectomy groups, and the total mastectomy and reconstruction after total mastectomy groups had similar quality of life. Efforts to evaluate and improve the quality of life of patients with breast cancer should be continued.

Breast reconstruction after mastectomy: does it decrease depression at the long-term?

“…In a cross-sectional study by Holly et al (22), depressive symptoms were equal in the mastectomy with and without BR groups, whereas more depressive symptoms were found in the mastectomy without BR group in other studies (12,23). Likewise, contrasting reports have been published regarding quality of life (QoL), which was equal for patients with and without BR after mastectomy in several studies (13,24), whereas a better QoL and better psychological/emotional functioning was presented in the BR group in other reports (8,10,11).…”

Assessing Outcomes After Breast Surgery: Patient and Clinician Reported Outcomes

“…There were, however, a minority of patients who reported that their body image has been very much affected by their surgery. In order to fully understand why some patients have more body image concerns, it is necessary to consider BIS scores in the context of their age, time since surgery and the type of surgery they underwent as well as look- Many studies have shown that the type of surgical procedure undergone has had an effect on post-surgical body image [18,19]. A similar study carried out in the UK showed that a significantly better body image was observed in patients after breast conservation compared with mastectomy with or without reconstruction [18].…”

“…In the above Japanese study, there was a higher Outcomes After Breast Surgery J Curr Surg. 2016;6(2):46-51 proportion of women in the mastectomy only group who had chemotherapy and axillary dissection, compared with MR and WLE [19]. These differences in disease prognosis may have influenced patient perspective on body image.…”

Psychological distress in patients with breast cancer after different antitumor treatments

“…Изучение психоэмоционального состояния 39 боль-ных РМЖ, перенесших РМЭ, и 28 больных, которым была произведена отсроченная реконструкция молоч-ной железы, показало ослабление на протяжении 1-6 лет признаков дистресса у всех пациенток, однако общий индекс тяжести дистресса был выше у послед-ней группы [20]. Качество жизни, связанное со здоро-вьем, с учетом психоэмоциональной сферы, по дан-ным [21], было выше у больных РМЖ, перенесших органосохраняющие операции, по сравнению с пере-несшими РМЭ с реконструкцией и без, а по данным [22,23] -у пациенток, перенесших РМЭ с одномо-ментной реконструкцией молочной железы.…”