Abstract:

Objective

To compare the quality of life in breast cancer patients receiving breast conserving surgery and the patients receiving mastectomy.

Methods

Totally 232 breast cancer patients who underwent either breast conserving surgery or mastectomy by the same group of doctors in Department of General Surgery, Xuanwu Hospital from January 2006 to December 2013 were involved according to the incision criteria. Quality of life was evaluated based on the European Organization for Research and Treatment of Cancer(EORTC) quality of life questionnaire C30 (QLQ-C30) and QLQ-BR23. From February 2014 to April 2015,a total of 207 patients completed the questionnaires and were divided into two groups:101 patients treated with breast conserving surgery and 106 with mastectomy. χ² test was used to compare the count data including axillary surgery, chemotherapy, radiotherapy, endocrine therapy and educational level. Z test was used for tumor staging data and t test was used to analyze the quality of life between two groups.

Results

The recovery rate of questionnaires was 89% (207/232). There was no significant difference in tumor stage, axillary surgery, chemotherapy and endocrine therapy between two groups(Z=-1.925,χ²=5.129,0.121,1.943; all P＞0.050). The percentage of patients receiving radiotherapy in breast conserving surgery group (91.1%,92/101) was significantly higher than that in mastectomy group (28.3%,30/106) (χ²=84.248, P＜0.001).The patients with high educational level (high school and above) accounted for 80.2% (81/101) in breast conserving surgery group, which was significantly higher than 60.3% (64/106) in mastectomy group (χ² =9.684,P=0.002). The results of QLQ-C30 showed that the scores of overall quality of life, physical function,role function, emotional function, cognitive function, social function, fatigue, nausea and vomiting, pain,dyspnoea, insomnia, appetite loss, constipation, diarrhoea and financial difficulty were not significantly different between two groups (t=0.456,2.297,2.106, -1.529, -0.400,0.689, -1.050,0.354, -1.219,-0.473,1.027, -0.118, 0.623, 0.179, -1.066, all P＞0.050). In QLQ-BR23, the patients in breast conserving surgery group showed a better body image(83.2±19.6 ) compared with mastectomy group (66.2±20.1) (t=4.854, P＜0.001). There were no significant differences in sexual functioning, sexual desire,future perspective, adverse reaction of systemic therapy, breast symptoms, upper extremity symptoms and anxiety caused by hair loss between two groups (t= -0.628, -0.874, -0.418, 0.000, -0.193, -0.457,0.774, all P＞0.050).

Conclusion

Patients with breast conserving surgery have a better body image than patients with mastectomy do, with no statistical difference in quality of life, worthy of clinical application.

Key words: Breast neoplasms, Mastectomy,segmental, Quality of life