Is quality of life after mastectomy comparable to that after breast conservation surgery? A 5-year follow up study from Mumbai, India

Abstract

Purpose Breast cancer is the commonest cancer in women worldwide. Surgery is a central part of the treatment. Modified radical mastectomy (MRM) is often replaced by breast conserving therapy (BCT) in high-income countries. MRM is still the standard choice, in low-and middle-income countries (LMICs) as radiotherapy, a mandatory component of BCT is not widely available. It is important to understand whether quality of life (QOL) after MRM is comparable to that after BCT. This has not been studied well in LMICs. We present, 5-year follow-up of QOL scores in breast cancer patients from India. Methods We interviewed women undergoing breast cancer surgery preoperatively, at 6 months after surgery, and at 1 year and 5 years, postoperatively. QOL scores were evaluated using FACT B questionnaire. Average QOL scores of women undergoing BCT were compared with those undergoing MRM. Total scores, domain scores and trends of scores over time were analyzed. Results We interviewed 54 women with a mean age of 53 years (SD 9 ± years). QOL scores in all the women, dipped during the treatment period, in all subscales but improved thereafter and even surpassed the baseline in physical, emotional and breast-specific domains (p < 0.05) at 5 years. At the end of 5 years, there was no statistically significant difference between the MRM and BCT groups in any of the total or domain scores. Conclusion QOL scores in Indian women did not differ significantly between MRM and BCT in the long term. Both options are acceptable in the study setting.

Assessment of Quality of Life in Patients of Mastectomy With Chemotherapy

“…Fatigue and pain are included in the symptom scale of the European Organization for Research and Treatment of Cancer (EQRTC) scale. Mean fatigue and pain and insomnia have been reported to be 33.3 ± 30.1 and 34.3 ± 32.6, respectively, similar to the present findings [ 27 ]. Fatigue and pain are reported to be the main problems along with hair loss in patients with breast cancer.…”

“…The psychological well-being of breast cancer patients was assessed on a 10-item questionnaire. Women suffering from breast cancer tend to have a higher risk of psychological problems [ 27 ]. Psychological scores show the difficulty that patients had regarding insight into their disease.…”

Quality of Life in Patients with Breast Cancer following Breast Conservation Surgery: A Systematic Review and Meta-Analysis

“…Dubashi et al's study [ 8 ] showed that the QOL and sexual function of the BCT group were marginally worse than those of the mastectomy group. Deepa et al's study [ 9 ] showed that QOL scores in Indian women did not differ significantly between mastectomy and BCT in the long term. Szutowicz-Wydra et al's study [ 13 ] showed that the global QOL of Polish breast cancer patients treated with BCT or mastectomy with BR was higher and does not differ between groups.…”

Quality of Life in Women Subjected to Surgical Treatment of Breast Cancer Depending on the Procedure Performed within the Breast and Axillary Fossa—A Single-Center, One Year Prospective Analysis

“…Moreover, a study carried out by Deepa et al provides us with even more interesting evidence. In a research conducted on women in India five years after surgery, the authors found no evidence of differences in the quality of life between patients who underwent BCT and mastectomy [ 21 ]. Other studies revealed better quality of life in terms of body image, as well as cognitive and role functioning, in patients subjected to BCT [ 22 ].…”