Dynamics in Quality of Life of Breast Cancer Patients Following Surgery: Systematic Review and Meta-Analysis

Background and Objectives: Surgical treatment is central to breast cancer management; however, its long-term impact on QoL varies substantially among patients. This study sought to model the dynamic trajectories of postoperative QoL following breast-conserving surgery (BCS), mastectomy with immediate reconstruction (Mx+IR), and mastectomy alone (MA). It also examined how these trajectories varied across different age groups and over time. Materials and Methods: The review and meta-analysis identified 150 peer-reviewed studies reporting QoL outcomes using validated instruments (EORTC QLQ-C30 or BREAST-Q). A total of 123 observations from 45 studies were included for analysis of global QoL. We standardized QoL scores to a 0-100 scale and harmonized postoperative assessments across six time intervals, extending to more than 73 months. Multilevel random-effects models evaluated linear, quadratic, and logarithmic functions. Subgroup analyses and meta-regressions assessed the moderating effects of surgical type and age. Results: BCS showed the steepest QoL gains, followed by Mx+IR, while MA had the lowest scores and slowest recovery. Compared to BCS, MA showed significantly poorer and delayed recovery, and Mx+IR showed a smaller, borderline decrease. All groups displayed modest long-term QoL plateauing. Conclusions: Global QoL after breast cancer surgery follows distinct, time-dependent patterns shaped by surgical approach and age. These findings emphasize the importance of discussing patients' quality-of-life expectations with them so that survivorship care can be personalized to their needs.