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

乳腺癌手术治疗对女性生活质量的影响:基于乳腺和腋窝手术方式的单中心、一年期前瞻性分析

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Abstract

The aim of this study was to evaluate the quality of life of patients undergoing surgical treatment of breast cancer depending on the type of procedure involving the breast (mastectomy vs. breast conserving treatment) and axillary fossa (sentinel lymph node biopsy vs. axillary lymph node dissection). The prospective study was carried out in a group of 338 females undergoing breast cancer treatment. Study variables were assessed by means of a diagnostic survey using standardized QLQ C30 and BR23 questionnaires as well as the Acceptance of Illness Scale and Mini-MAC scales. The quality of life was assessed at threetime points: on the day before the surgical procedure (I assessment) as well as three and 12 months after surgery (II and III assessment). Statistically significant differences between study groups were observed in the overall quality of life subscale (I, II, III-p < 0.0001), physical functioning (I-p < 0.0001; II-p = 0.0413; III-p < 0.0001), role functioning (I-p = 0.0002; III-p < 0.0001), emotional functioning (III-p = 0.0082), cognitive functioning (I-p = 0.0112; III-p < 0.0001), social functioning (III-p < 0.0001), body image (I, II, III-p < 0.0001), and sexual functioning (I-p = 0.0233; III-p = 0.0011). In most symptomatic scales, significant (p < 0.05) differences were also noted. Mastectomy and limfadenectomy patients were significantly (p < 0.0001) more prone to present with destructive coping strategies one year after surgery. Breast conserving therapy is associated with better quality of life outcomes as compared to mastectomy. Sentinel lymph node biopsy is associated with a lower intensity of adverse changes in multiple dimensions of patients' functioning.

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