Abstract
Objective : The objective of this prospective study was to evaluate the age-related long-term psychosocial morbidity development and health-related quality of life outcomes among diseasefree outdoor breast cancer patients previously treated for early-stage breast cancer by breast conserving surgery (BCS). Methods: 140 eligible disease-free breast cancer patients previously treated by BCS or modified radical mastectomy (MRM) and surviving without tumor recurrence and any comorbidities for three years after surgery were recruited for the survey. The assessment was conducted one and three years after surgery using the standardised EORTC Quality of Life QLQ C3O.3 questionnaire, the breast cancer specific module QLQ BR-23 and the Hospital Anxiety and Depression Scale (HADS) questionnaire. Results: Scoring of cancer-specific quality of life and psychosocial morbidity over the time between one and three years after surgery have shown that patients with advanced breast cancer previously treated by modified radical mastectomy (MRM) suffered from steady-state level of psychosocial distress and low quality of life perception during the entire period of observation. On the other hand, nearly 70% of breast cancer patients treated by BCS were surviving without profound impact onto psychosocial status and health-related quality of life during the entire observation period. However, scoring of distress symptoms brought evidence indicating that nearly one third of patients surviving more than three years after BCS were suffering from emotional distress due to increasing anxiosity, nervousness, uncertainty and fear about future. Patients with higher psychosocial burden mainly belong to younger population aging between 35 to 50 years. In these patients, the health-related quality of life scores were lower and sometimes comparable with those of MRM-treated patients. The low quality of life and increased psychosocial distress in young
Highlights
The quality of life of breast cancer survivors beyond the acute phase of treatment have been the subject of several clinical studies (Perry et al 2007, Arndt et al 2008, Ganz 2008)
Scoring of cancer-specific quality of life and psychosocial morbidity over the time between one and three years after surgery have shown that patients with advanced breast cancer previously treated by modified radical mastectomy (MRM) suffered from steady-state level of psychosocial distress and low quality of life perception during the entire period of observation
Nearly 70% of breast cancer patients treated by breast conserving surgery (BCS) were surviving without profound impact onto psychosocial status and health-related quality of life during the entire observation period
Summary
The quality of life of breast cancer survivors beyond the acute phase of treatment have been the subject of several clinical studies (Perry et al 2007, Arndt et al 2008, Ganz 2008). Despite the efficacy of non-invasive treatment with breast conservation, patients treated with lumpectomy face a risk of cancer recurrence. In both breast cancer patients groups, the breast cancer risk status is leading to the development of psychosocial morbidity reflected by anxiety, fears, concerns, uncertainty, emotional disruption, loss of personal functioning, nervousness, physical disruptions, fatigue and social isolation (Moyer 1997, Klassen et al 2009). The emotional burden of these patients is frequently considered irrelevant and their psychosocial support needs are neglected despite the fact that psychosocial parameters associated with breast cancer and its treatment are dysfunctioning social network, minimization, denial and coping and may predict patient‘s survival ( Petigrew et al 2002, Kroenke et al 2006, Phillips et al 2008)
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