Quality of Life After Breast Cancer Surgery in Patients Receiving Adjuvant Radiotherapy: A Cross-Sectional Analysis

As breast cancer survivorship improves, quality of life (QoL) has become a key determinant in treatment decision-making. While breast-conserving approaches are widely adopted, variations in surgical extent persist across clinical settings. This study aimed to compare patient-reported QoL scores between women undergoing breast-conserving surgery and those undergoing modified radical mastectomy in the context of adjuvant radiotherapy.

This single-center, cross-sectional, observational study included 98 women who were treated at a tertiary hospital between January 2021 and January 2024. Of 200 potentially eligible patients contacted, 98 consented and completed the European Organisation for Research and Treatment of Cancer core quality of life questionnaire (QLQ-C30) and the breast cancer-specific module (QLQ-BR23) after radiotherapy. Fifty-eight patients underwent breast-conserving surgery, and 40 underwent modified radical mastectomy. Scores were transformed to a 0-100 scale; functional and global health scales were interpreted conventionally, and symptom summaries were oriented so that higher scores reflected lower symptom burden. Unadjusted group comparisons were performed using the Mann-Whitney U test, and exploratory correlations were assessed using Spearman correlation coefficients.

Patients treated with breast-conserving surgery reported higher QLQ-C30 functional scores than those treated with modified radical mastectomy (median 60.00 vs. 46.66; p = 0.005) and higher global health status scores (66.66 vs. 37.50; p<0.001). Symptom summary scores also favored breast conservation (67.94 vs. 58.97; p = 0.001). On the QLQ-BR23, the breast-conserving group reported higher functional scores (57.77 vs. 44.44; p = 0.008) and higher symptom summary scores (87.50 vs. 84.38; p = 0.045). These values represent unadjusted between-group differences and should be interpreted in light of the observational design and the unavailability of clinical covariates.

In patients receiving adjuvant radiotherapy, less extensive breast surgery was associated with more favorable patient-reported quality of life outcomes. These findings highlight the importance of incorporating survivorship outcomes into shared decision-making in breast cancer care.