Abstract
Axillary lymph node dissection (ALND) remains a standard component in the management of breast cancer; however, it may have lasting impacts on patients' health-related quality of life (HRQOL). This study aimed to assess HRQOL and identify its demographic and clinical correlates among breast cancer survivors who underwent ALND. This cross-sectional study was conducted among breast cancer survivors post-ALND at a tertiary oncology center in Alexandria, Egypt. HRQOL was measured using the Arabic FACT-B (version 4.0), and the associated factors were analyzed using multivariate analysis of variance (MANOVA). A total of 150 breast cancer survivors completed the FACT-B questionnaire, with a mean HRQOL score of 88.92 ± 18.01. Of the participants, 18.7% had poor, 64.0% had moderate, and 17.3% had good HRQOL. MANOVA showed that the type of surgery, BMI, HER2 status, lymph node involvement, and tumor stage were significantly associated with HRQOL (p < 0.05). Between-subject analyses and post hoc comparisons confirmed significant group differences across the FACT-B subscales. Overweight or obese participants had poorer Physical, Emotional, and Functional Well-Being. Mastectomy, HER2-positive status, and Stage III disease were associated with lower HRQOL across multiple domains, while lymph node involvement impacted the Physical Well-Being subscale only. Integrating routine HRQOL assessment into survivorship care is essential for identifying individuals at a higher risk of poor outcomes. Tailored follow-up strategies and supportive interventions for these subgroups can enhance the long-term well-being and improve the overall post-treatment quality of life of breast cancer survivors.