Comparison of Long-Term Health-Related Quality of Life After Mastectomy and Breast Conserving Therapy

Breast cancer and its treatments have a significant impact on patients' health-related quality of life (HRQL). The aim of this study was to compare HRQL in a long-term, cross-sectional assessment after breast conserving therapy (BCT) and mastectomy without reconstruction, using the BREAST-Q.

Altogether 500 patients who had undergone either mastectomy or BCT between 06/2016 and 8/2018 were approached. The postoperative HRQL was assessed using the BREAST-Q Breast Conserving Therapy and Mastectomy Modules.

A total of 171 (34%) women participated, 85 of whom had undergone BCT and 86 mastectomy without reconstruction. The mean (SD) time from surgery to the survey was 3.3 (1) years. The mean age of the participants did not differ in the groups (p = 0.45). Compared to those who had undergone mastectomy, women with a history of BCT reported better psychosocial well-being (78 (19) vs. 66 (17), p < 0.01), sexual well-being (61 (20) vs. 41 (22), p < 0.01) and physical well-being of the chest (86 (16) vs. 77 (20), p < 0.01). They were also more satisfied with their breasts (72 (22) vs. 52 (17), p < 0.01) and reported fewer radiotherapy side effects (7 (1) vs. 8 (3), p = 0.01).

These data suggest that the long-term HRQL remains high after both BCT and mastectomy. However, women with a history of BCT reported higher psychosocial, sexual, and physical well-being and greater satisfaction with their breasts than those with a history of mastectomy.