Abstract
BackgroundBreast cancer and its treatment imposes a significant effect in the quality of life (QOL) of women. Being a developing country with contrasting social and cultural norms to the West, Sri Lankan women may have a different experience on QOL following surgical treatment of breast cancer. This study was conducted to evaluate post-treatment QOL in breast cancer patients and to determine its association with the type of surgery.MethodsA cross sectional study was carried out. Fifty four women with non-metastatic breast cancer who underwent surgery for breast cancer at the Professorial Surgical Unit, Colombo during 2015–2018 and completed a minimum of one year follow up after surgery were invited to participate. Fifty-four women who responded were assessed using the validated EORTC QLQ-C30 and QLQ-BR23 questionnaires. Non-parametric tests were used for statistical analyses.ResultsThe mean age was 59 years (range 36–81). A majority (61%, n = 35) underwent mastectomy and the rest (n = 19, 45%) breast conservation surgery (BCS). The mean QLQ-C30 score was 68.8 (range 8.3–100) and the mean scores for physical function, role function, emotional function, cognitive function, and social function were 71.4, 81.5, 77.0, 80.2, and 86.4, respectively. The mean scores for body image, sexual functioning, sexual enjoyment, future perspective, systemic therapy, breast symptoms, arm symptoms, and hair loss assessed by the QLQ-BR23 were 76.4, 18.3, 33.3, 73.6, 30.5, 16.2, 23.4 and 32.7, respectively. No significant differences (P > 0.05) were noted in global health status, physical function, role function, emotional function, cognitive function and social function between BCS and mastectomy. QLQ-BR23 body image, sexual functioning, sexual enjoyment and future perspective also did not differ significantly (p > 0.05) between the two groups.ConclusionsSexual functioning and enjoyment, breast and arm symptoms and hair loss contributed to poor QOL while the impact on global health status including physical, social and emotional functions were minimal. Type of surgery did not appear to be associated with QOL. Future studies with a larger sample sizes will be helpful to further study these factors.
Highlights
Breast cancer and its treatment imposes a significant effect in the quality of life (QOL) of women
In Sri Lanka, breast cancer is the commonest malignancy with an increasing incidence, especially in the post-menopausal women [2, 3]
The parameters assessed by the QLQ BR-23 such as body image (p = 0.37), sexual functioning (p = 0.17), sexual enjoyment (p = 0.28), future perspective (p = 0.94), systemic therapy (p = 0.81), breast symptoms (p = 0.46), arm symptoms (p = 0.18), and hair loss (p = 0.859) were similar in the two groups who underwent breast conservation surgery (BCS) compared with mastectomy (Table 2). This cross-sectional study evaluated the post-treatment QOL in Sri Lankan female patients diagnosed with breast cancer using the validated EORTC QLQ-C30 and BR-23 tools have shown substantially poor QOL in sexual functioning and enjoyment, breast and arm symptoms and hair loss domains while the impact on global health status including physical, social and emotional functions were minimal
Summary
Breast cancer and its treatment imposes a significant effect in the quality of life (QOL) of women. Advancements in diagnosis and treatment have substantially improved the survival rates from breast cancer over last two to three decades with a majority of women achieving a complete cure [4, 5]. These advances would add ‘years to patients’ lives’, it may not add ‘life to patients’ years’ shifting the focus towards improving the quality of life of patients [6]. QOL in these women is affected due to the morbidity linked with the treatment and due to the additional burden from psychosocial aspects such as changes in lifestyle, sexual dysfunction, and alteration of body image [6]
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