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.

Magdalena Tarkowska,Tomasz Nowikiewicz,Iwona Głowacka-Mrotek,Aleksander Goch,Wojciech Zegarski

doi:10.3390/jcm10071339

Magdalena Tarkowska, Tomasz Nowikiewicz + Show 3 more

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https://doi.org/10.3390/jcm10071339

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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.

Highlights

The results suggest poorer emotional functioning of patients qualified for mastectomy as compared to breast conserving treatment (BCT) as well as patients qualified for axillary lymph node dissection (ALND) as compared to sentinel lymph node biopsy (SLNB)
The results indicate that patients qualified for mastectomy were more likely to report adverse reactions compared to patients subjected to BCT
The results of our studies are indicative of the quality of life being significantly lower in many functional aspects in patients subjected to mastectomy as compared to patients undergoing BCT

Summary

Introduction

Breast cancer is the most prevalent malignancy in women in Poland and highly developed countries [1]. The treatment of breast cancer is referred to as combination treatment. Two surgical modalities are available, including mastectomy and breast conserving treatment (BCT); with regard to the local lymphatic system, surgeries may involve axillary lymph node dissection (ALND) or sentinel lymph node biopsy (SLNB). The mainstay of the therapeutic regimen consists in surgical procedure supplemented by various adjuvant treatments [2]

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