Quality of Life Following Modified Radical Mastectomy for Breast Cancer in Haiti

This study evaluated health-related quality of life (HRQoL), anxiety, and depression among Haitian women following modified radical mastectomy (MRM).

This cross-sectional study included women who underwent MRM for breast cancer between 2018 and 2023. Clinical data were abstracted from medical records, and participants completed the multidimensional Functional Assessment of Cancer Therapy-Breast (FACT-B) and the Hospital Anxiety and Depression Scale (HADS). FACT-B well-being subscales (physical, social, emotional, functional, and breast-specific) and total scores were summarized descriptively. Nonparametric tests and logistic regression were used to assess group differences and associations.

The cohort included 85 women, with a median age 50 years (IQR, 43-58). Most were postmenopausal (83.5%), had locally advanced disease (65.9%), and were unemployed (77.7%). Nearly all received systemic chemotherapy (98.8%). The median FACT-B score was 111.5 (IQR, 97.2-122.7), reflecting favorable HRQoL. Younger women (<50 years) reported the lowest emotional well-being scores compared with women age 50-60 and >60 years (P = .002). There were significant differences in multiple subscales by type of systemic chemotherapy received including physical (P = .02), emotional (P = .007), and breast-specific scores (P = .04); women who received both neoadjuvant and adjuvant chemotherapy had lowest scores compared with those treated with neoadjuvant or adjuvant therapy alone. The median HADS-A score of 8 (IQR, 6-11) and HADS-D score of 13 (IQR, 12-15) correspond to mild anxiety and moderate depression. Women <50 years also had a higher prevalence of anxiety (P = .01).

Overall HRQoL after MRM was favorable, but anxiety and moderate-to-severe depressive symptoms were widespread across the cohort. Younger women are particularly vulnerable and represent a priority population for integrated mental health support.