Effect of cosmetic outcome on quality of life after breast cancer surgery.
PURPOSE
Studies regarding the effects of aesthetic outcomes after breast cancer surgery on quality of life (QoL) have yielded inconsistent results. This study analyzed the aesthetic outcomes and QoL of women who underwent breast conserving surgery (BCS) or total mastectomy with immediate reconstruction (TMIR) using objective and validated methods.


PATIENTS AND METHODS
QoL questionnaires (EORTC QLQ-C30, BR23, and HADs) were administered at least 1 year after surgery and adjuvant therapy to 485 patients who underwent BCS, 46 who underwent TMIR, and 87 who underwent total mastectomy (TM) without reconstruction. Aesthetic results were evaluated using BCCT.core software and by a panel of physicians. Patients' body image perception was assessed using the body image scale (BIS).


RESULTS
QoL outcomes, including for social and role functioning, fatigue, pain, body image, and arm symptoms, were significantly better in the BCS and TMIR groups than in the TM group (p<0.05 each). BIS was significantly better in the BCS than in the TM or TMIR group (p<0.001 each). In the BCS and TMIR groups, general QoL factors were not significantly associated with objective cosmetic outcomes, except for body image in the QLQ-BR23. In contrast, patients with poorer BIS score reported lower QoL in almost all items of the QLQ-C30, BR23, and HADS (p<0.05 each).


CONCLUSION
In conclusion, BCS and TMIR enhanced QoL compared with TM. Among BCS and TMIR patients, objectively measured cosmetic results did not affect general QoL. Self-perception of body image seems to be more important for QoL after breast cancer surgery.
['Kim|M K|MK|', 'Kim|T|T|', 'Moon|H G|HG|', 'Jin|U S|US|', 'Kim|K|K|', 'Kim|J|J|', 'Lee|J W|JW|', 'Kim|J|J|', 'Lee|E|E|', 'Yoo|T K|TK|', 'Noh|D-Y|DY|', 'Minn|K W|KW|', 'Han|W|W|']
D000328:Adult D001828:Body Image D001943:Breast Neoplasms D005260:Female D006801:Humans D016462:Mammaplasty D015412:Mastectomy, Segmental D015413:Mastectomy, Simple D008875:Middle Aged D017060:Patient Satisfaction D011788:Quality of Life D016896:Treatment Outcome
Quality of life Breast cancer BCCT.core Body Image Scale Cosmetic result