Long-Term Patient Satisfaction and Quality of Life After Breast-Conserving Therapy: A Prospective Study Using the BREAST-Q

Abstract

Background Poor patient-reported satisfaction after breast-conserving therapy (BCT) has been associated with impaired health-related quality of life (HRQOL) and subsequent depression in retrospective analysis. This prospective cohort study aimed to assess the HRQOL of patients who have undergone BCT using the BREAST-Q, and to identify clinical risk factors for lower patient satisfaction. Methods Patients with primary breast cancer undergoing BCT were asked to complete the BREAST-Q preoperatively (T1) for baseline evaluation, then 3 to 4 weeks postoperatively (T2), and finally 1 year after surgery (T3). Clinicopathologic data were extracted from the patients’ charts. Repeated measures analysis of variance (ANOVA) was used to determine significant differences in mean satisfaction and well-being levels among the test intervals. Multiple linear regression was used to evaluate risk factors for lower satisfaction. Results The study enrolled 250 patients. The lowest baseline BREAST-Q score was reported for “satisfaction with breast” (mean, 61 ± 19), but this increased postoperatively (mean, 66 ± 18) and was maintained at the 1 year follow-up evaluation (mean, 67 ± 21). “Physical well-being” decreased from T1 (mean, 82 ± 17) to T2 (mean, 28 ± 13) and did not recover much by T3 (mean, 33 ± 13), being the lowest BREAST-Q score postoperatively and in the 1-year follow-up evaluation. In multiple regression, baseline psychosocial well-being, body mass index (BMI), and type of incision were risk factors for lower “satisfaction with breasts.” Conclusion Both the aesthetic/surgery-related and psychological aspects are equally important with regard to “satisfaction with breasts” after BCT. The data could serve as the benchmark for future studies.

A Systematic Review of the Impact of Patient Factors on BREAST-Q Outcomes After Reduction Mammoplasty

“…Notably, our results also demonstrated a lack of correlation between complication rates and the average change between preoperative and postoperative BREAST-Q scores. These data can be extrapolated to suggest that adverse outcomes did not seem to outweigh the positive impact of reduction mammoplasty on QoL over time, which is reinforced by prior reports in the literature 18,22,35,36 . Still, prior studies have noted a negative relationship between complication rates and BREAST-Q satisfaction outcomes, 37 and future research delineating complications into major and minor categories could help clarify this association further.…”

The Role of Social Media in Breast Cancer Care and Survivorship: A Narrative Review

“…Interestingly, two additional themes relevant to patient QoL, “complementary and alternative medicine,” as well as the relationships between the patients and their relatives, were also identified, and the authors recommended incorporating these emerging subjects into existing QoL questionnaires [48]. Postoperative aesthetic outcome and body image perception, physical, social, sexual, and cognitive functioning also present crucial QoL aspects for BC patients [10, 49, 50]. These parameters could be further explored by analysing social media content, which would allow for country of origin and cultural background to be taken into account and in turn allow for relevant content to be offered to the appropriate patient groups [51].…”

Factors Associated with Health-Related Quality of Life Among Breast Cancer Survivors in the Saudi Arabia: Cross Sectional Study

“…HRQOL has been extensively studied in western countries. These studies have found that BC survivors reported poor HRQOL with reduced physical and emotional function, and experienced major psychological symptoms relative to those without a cancer history [7,[9][10][11][12][13][14][15]. In addition, thesis studies have identi ed that age, socioeconomic status, disease stage and types of surgery, psychological factors and fear of recurrence may in uence perceptions of HRQOL [9][10][11][12][13][14][15].…”

“…These studies have found that BC survivors reported poor HRQOL with reduced physical and emotional function, and experienced major psychological symptoms relative to those without a cancer history [7,[9][10][11][12][13][14][15]. In addition, thesis studies have identi ed that age, socioeconomic status, disease stage and types of surgery, psychological factors and fear of recurrence may in uence perceptions of HRQOL [9][10][11][12][13][14][15]. Unfortunately, ndings from the western population cannot be generalized to breast cancer women in the Arab populations, due to diversity in ethnicity, lifestyle and self-perception of the disease, social constraints, and other religious/cultural issues [16][17][18][19].…”