Health-related quality of life: Impact of surgery and treatment modality in breast cancer.

Abstract

Breast cancer is the most common malignancy among women leading to serious sequelae on the health-related quality of life (HRQOL). This is a cross-sectional study. The Arabic version of EORTC QLQ-C30 (version 3) and EORTC QLQ-BR23 questionnaire was administered to a random sample of 172 Egyptian women with breast cancer. One hundred and nineteen patients had modified radical mastectomy (MRM) and 53 had breast conservative surgery (BCS). The mean age was 50.32 years (±standard deviation [SD] = 8.54) with a mean period of 4.75 years (±SD 3.33) from surgery. The global health was poor (28.38 ± 11.7, 95% confidence interval [95% CI]: 30.71). Among the functional scales of QLQ-C30, social functioning scored the highest (87.91 ± 17.92, 95% CI: 91.64) whereas emotional functioning scored the lowest (59.61 ± 24.96, 95% CI: 64.66). The most distressing symptom on the symptom scales of QLQ-C30 was financial impact followed by fatigue and pain (mean: 57.87, 39.43, and 36.44). Using the disease-specific tools, it was found that body image and sexual functioning scored the lowest (mean 74.51 ± 13.21 and 74.45 ± 14.89, 95% CI: 77.27 and 77.55), respectively. On the symptom scale, arm symptoms scored the highest with a mean of 32.35 ± 23.22 (95% CI: 37.19). MRM patients had more favorable global health status and body image among the functional scale (P = 0.011, 0.027) due to social and religious issues. The functional scale was better in BCS with significant role function (P = 0.004). In the symptom scale, fatigue, pain, systemic side effects, and arm symptoms were statistically significant better in the BCS (P = 0.004, 0.006, 0.002, and 0.003, respectively). Egyptian breast cancer survivors reported lower overall global QOL. HRQOL is better in BCS in spite of good global health and body image in MRM.