[The dynamics of psychosocial burden development in breast cancer survivors: clinical success with psychosocial consequences].

BACKGROUNDS: Modified radical mastectomy (MRM) and breast-conserving surgery (lumpectomy, quadrantectomy - BCS) have shown equivalent clinical outcome in early stage breast cancer. On the other hand, quality of life and, probably, survival time of these patients are negatively influenced by fear of cancer recurrence, leading to episodes of anxiety, depression, and frustration, and, subsequently, physical, marital, sexual, and social functioning disorders. The aim of the present study was to analyze the dynamics and qualitative changes in psychosocial morbidity outcomes in breast cancer survivors one and three years after MRM versus BCS.

METHODS: A survey evaluating psychosocial morbidity of patients was performed by distributing Slovak version of the standardised EORTC-QLQ.C30:3 and EORTC-QLQ-BR23 questionnaires provided by the European Organisation for Research and Treatment of Cancer. The survey was performed in both arms of breast cancer patients surviving one and three years after MRM versus BCS.

RESULTS: Patients surviving one year post MRM or BCS scored their quality of life rather low (2-4, very bad - acceptable), while 78% patients surviving three years after BSC scored considerably higher (5-6, good - very good). However, 22% of patients in this arm considered their quality of life bad, scoring comparably with patients in the MRM arm. While psychosocial burden and behavioural risk profile remain fully expressed in MRM-treated breast cancer patients three years post surgery, the patients surviving three years after BCS suffer from significant emotional dysfunction.

CONCLUSION: The shift in the quality and intensity of psychosocial dysfunction symptoms in breast cancer patients surviving three years after BCS requires greater attention related to the need for appropriate community-based psychosocial interventions and psychosocial prevention due to the negative impact of continuing and even accelerated psychosocial distress on the quality of life of surviving patients and remission period of the malignant disease.