[Health-related quality of live in breast cancer patients--actuality and problems]

Women with early breast cancer have three surgical options fir this current moment: conservative treatment (lumpectomy, quadrantectomy); mastectomy alone and mastectomy plus reconstruction (immediate or delayed). When randomized trials showed oncological safety of breast--conservative treatment compared with mastectomy, the question of cosmetic results assessment become actual, because of its impact on quality of live. The current state of the art permits achievement of good oncological results and good cosmetics ones. There are some technical factors affecting cosmetic results after breast--conservative treatment: orientation of resection; the breast / resection ratio; tumor localization; orientation of axillary dissection. Combination of extended resection (quadrantectomy) plus axillary dissection through the same incision results in cosmetic failure. After operation there is a remarkable breast asymmetry, retraction of the mammilla and inferior contour distortion. The main reasons for cosmetic failures are: volume of resection (lumpectomy, quadrant-ectomy), postoperative radiotherapy, deviation from normal breast morphology and tumor location. There are a lot of questionnaires for quality of live assessment. For Bulgarian population N. Mashonov created and adopted original questionnaire. The author investigated quality of live among patients with hard failure during recovery period.