TY - JOUR
T1 - Dynamic changes in quality of life, psychological status, and body image in women who underwent a mastectomy as compared with breast reconstruction
T2 - an 8-year follow up
AU - Konara Mudiyanselage, Sriyani Padmalatha
AU - Wu, Yi Lin
AU - Kukreti, Shikha
AU - Chen, Chang Chun
AU - Lin, Chia Ni
AU - Tsai, Yi Tseng
AU - Ku, Han Chang
AU - Fang, Su Ying
AU - Wang, Jung Der
AU - Ko, Nai Ying
N1 - Funding Information:
I am especially indebted to the National Cheng Kung university to support funding for my studies. Also, I wish to express my appreciation for those who had helped with the English editing of the manuscript.
Funding Information:
The collection of patient’s reported outcome data was supported by serial grants from the Ministry of Science and Technology (MOST 108-2627-M-006-001, MOST 109-2621-M-006-007, MOST 110-2627-M-006-010). The funder had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.
Publisher Copyright:
© 2022, The Author(s), under exclusive licence to The Japanese Breast Cancer Society.
PY - 2023/3
Y1 - 2023/3
N2 - Background: Surgical decisions and methods of surgery highly influence long term QoL for breast cancer (BC) survivors. This study is aimed towards an exploration of the dynamic changes in quality of life (QoL), anxiety/depression status, and body image (BI) among women with BC who received a mastectomy compared with those receiving breast reconstruction (BR) within an 8-year follow-up period. Methods: Women with major BC surgeries were invited to complete the World Health Organization Quality of Life–Brief (WHOQOL-BREF), the European quality of life five dimensions questionnaire (EQ-5D), and a body image scale within 8 years of surgery. Kernel smoothing methods were applied to describe dynamic changes in QoL, anxiety/depression, and BI at different time points. Linear mixed effects models were constructed to identify the interaction between time, different types of surgery, and the determinants of QoL in these patients. Results: After 1:10 propensity score matching, a total of 741 women who had undergone a BR and mastectomy were included. The BR group exhibited a high WHOQOL QoL score one to five years after surgery with some fluctuations. The mastectomy group had comparatively stable QoL scores on WHOQOL items and were less depressed/anxious. The BR group generally showed fluctuating, higher BI scores two years after surgery, but they exhibited more anxiety/depression during follow up for 8 years. Medical comorbidities, the status of anxiety/depression, and BI were the major factors influencing all domains and items of the WHOQOL BREF among women with BC. Conclusion: The mastectomy group showed a decreased trend toward depression in patients with BC. The BR group showed a significant improvement in QoL in the first 5 years with massive fluctuations. These findings should be considered and discussed in patient participatory decision-making and promotion of QoL for breast cancer survivors.
AB - Background: Surgical decisions and methods of surgery highly influence long term QoL for breast cancer (BC) survivors. This study is aimed towards an exploration of the dynamic changes in quality of life (QoL), anxiety/depression status, and body image (BI) among women with BC who received a mastectomy compared with those receiving breast reconstruction (BR) within an 8-year follow-up period. Methods: Women with major BC surgeries were invited to complete the World Health Organization Quality of Life–Brief (WHOQOL-BREF), the European quality of life five dimensions questionnaire (EQ-5D), and a body image scale within 8 years of surgery. Kernel smoothing methods were applied to describe dynamic changes in QoL, anxiety/depression, and BI at different time points. Linear mixed effects models were constructed to identify the interaction between time, different types of surgery, and the determinants of QoL in these patients. Results: After 1:10 propensity score matching, a total of 741 women who had undergone a BR and mastectomy were included. The BR group exhibited a high WHOQOL QoL score one to five years after surgery with some fluctuations. The mastectomy group had comparatively stable QoL scores on WHOQOL items and were less depressed/anxious. The BR group generally showed fluctuating, higher BI scores two years after surgery, but they exhibited more anxiety/depression during follow up for 8 years. Medical comorbidities, the status of anxiety/depression, and BI were the major factors influencing all domains and items of the WHOQOL BREF among women with BC. Conclusion: The mastectomy group showed a decreased trend toward depression in patients with BC. The BR group showed a significant improvement in QoL in the first 5 years with massive fluctuations. These findings should be considered and discussed in patient participatory decision-making and promotion of QoL for breast cancer survivors.
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U2 - 10.1007/s12282-022-01413-6
DO - 10.1007/s12282-022-01413-6
M3 - Article
C2 - 36319889
AN - SCOPUS:85141212841
SN - 1340-6868
VL - 30
SP - 226
EP - 240
JO - Breast Cancer
JF - Breast Cancer
IS - 2
ER -