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

Background: Breast cancer is the most common malignancy among women leading to serious sequelae on the health-related quality of life (HRQOL).

Materials and Methods: 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).

Results: 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).

Conclusion: 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.