Long-Term Patient Satisfaction and Quality of Life After Breast-Conserving Therapy: A Prospective Study Using the BREAST-Q

Ann Surg Oncol. 2021 Dec;28(13):8742-8751. doi: 10.1245/s10434-021-10377-4. Epub 2021 Jul 19.

Abstract

Background: Poor patient-reported satisfaction after breast-conserving therapy (BCT) has been associated with impaired health-related quality of life (HRQOL) and subsequent depression in retrospective analysis. This prospective cohort study aimed to assess the HRQOL of patients who have undergone BCT using the BREAST-Q, and to identify clinical risk factors for lower patient satisfaction.

Methods: Patients with primary breast cancer undergoing BCT were asked to complete the BREAST-Q preoperatively (T1) for baseline evaluation, then 3 to 4 weeks postoperatively (T2), and finally 1 year after surgery (T3). Clinicopathologic data were extracted from the patients' charts. Repeated measures analysis of variance (ANOVA) was used to determine significant differences in mean satisfaction and well-being levels among the test intervals. Multiple linear regression was used to evaluate risk factors for lower satisfaction.

Results: The study enrolled 250 patients. The lowest baseline BREAST-Q score was reported for "satisfaction with breast" (mean, 61 ± 19), but this increased postoperatively (mean, 66 ± 18) and was maintained at the 1 year follow-up evaluation (mean, 67 ± 21). "Physical well-being" decreased from T1 (mean, 82 ± 17) to T2 (mean, 28 ± 13) and did not recover much by T3 (mean, 33 ± 13), being the lowest BREAST-Q score postoperatively and in the 1-year follow-up evaluation. In multiple regression, baseline psychosocial well-being, body mass index (BMI), and type of incision were risk factors for lower "satisfaction with breasts."

Conclusion: Both the aesthetic/surgery-related and psychological aspects are equally important with regard to "satisfaction with breasts" after BCT. The data could serve as the benchmark for future studies.

MeSH terms

  • Humans
  • Patient Satisfaction*
  • Prospective Studies
  • Quality of Life*
  • Retrospective Studies
  • Surveys and Questionnaires