Extensive surgery in young breast cancer survivors tied to poorer QOL outcomes: JAMA

The primary outcome was mean BREAST-Q breast satisfaction and physical, psychosocial, and sexual well-being scores were compared by type of surgery; higher BREAST-Q scores (range, 0-100) indicate better QOL.

Linear regression was used to identify demographic and clinical factors associated with BREAST-Q scores for each domain.

The results of the study are as follows:

• A total of 560 women with stage 0 to III breast completed the BREAST-Q within a median of 5.8 years from diagnosis.
• A total of 290 patients (52%) of patients underwent a bilateral mastectomy, 110 patients (20%) underwent a unilateral mastectomy, and 160 patients (28%) received breast-conserving therapy.
• Among mastectomy patients, 357 (89%) had reconstruction and 181 (45%) received radiotherapy.
• In multivariate analyses, implant-based reconstruction (vs autologous) was associated with decreased breast satisfaction and complex reconstruction (vs autologous) with worse physical well-being.

Thus, the researchers concluded that local therapy in young breast cancer survivors is persistently associated with poorer scores in multiple QOL domains, particularly among those treated with mastectomy and radiotherapy, irrespective of breast reconstruction. Socioeconomic stressors also appear to play a role.

Reference:

Association of Local Therapy with Quality-of-Life Outcomes in Young Women with Breast Cancer by Dominici, L et. al published in the JAMA Surgery.

doi:10.1001/jamasurg.2021.3758