Quality of Life Following Breast-Conserving Therapy or Mastectomy: Results of a 5-Year Prospective Study

Abstract

There are many conflicting results in the literature comparing quality of life following breast-conserving therapy (BCT) and mastectomy. This study compared long-term quality of life between breast cancer patients treated by BCT or mastectomy in three age groups. Patients (n = 990) completed a quality of life survey, including the European Organization for Research and Treatment of Cancer Quality of Life Core Questionnaire (EORTC QLQ-C30), at regular intervals over 5 years. In the cross-sectional data, mastectomy patients had significantly (p < 0.01) lower body image, role, and sexual functioning scores and their lives were more disrupted than BCT patients. Emotional and social functioning and financial and future health worries were significantly (p < 0.01) worse for younger patients. There were no differences in body image and lifestyle scores between age groups. There was also no interaction between age and surgery method. Even patients > or =70 years of age reported higher body image and lifestyle scores when treated with BCT. The repeated measures analysis indicated that four functioning scores, half the symptom scores, future health, and global quality of life improved significantly (p < 0.01) over time. All these variables increased significantly for BCT patients and those 50 to 69 years of age. Body image, sexual functioning, and lifestyle disruption scores did not improve over time. BCT should be encouraged in all age groups. Coping with appearance change should be addressed in patient interventions.

Process of Coping with Mastectomy: a Qualitative Study in Iran

“…Engle et al (2004) in their study, found that many patients assume they would experience a situation like organ removal after mastectomy. For this reason, they often look for treatments other than mastectomy not to lose the organ which is sign of being female and mother for them (Engle et al, 2004).…”

Iatrogenic and Post‐Traumatic Female Sexual Disorder

“…Mastectomy patients had significantly (p<0.01) lower body image, role and sexual functioning scores, and their lives were overall more disrupted than breast-conserving therapy patients [40]. Importantly, body image, sexual functioning and lifestyle disruptions did not improve over time [40].…”

“…Importantly, body image, sexual functioning and lifestyle disruptions did not improve over time [40]. Breast conserving therapy, when oncologically appropriate, should be encouraged in all age groups.…”

“…When severe, it may impair body image even more than breast surgery per se. The incidence of lymphedema ranges from 6% up to 62.5% [8,[40][41][42]. Disfigured body image and self perception may affect the inner sense of femininity, leading to depression and avoidant coping strategies.…”

A oncopsiquiatria no câncer de mama: considerações a respeito de questões do feminino

“…Uma decisão favorável para essa modalidade de tratamento -a lumpectomia -pode ter repercussão imediata na saúde mental da mulher pela questão da "imagem corporal", um termo que, segundo Engel et al (2004), é falho em descrever a complexidade da experiência psicossocial em perder uma mama.…”