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Evaluation of quality of life in breast cancer patients who underwent breast-conserving surgery or mastectomy using real-world data

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Abstract

Background

Due to advances in the fight against breast cancer, aesthetic aspects and the prevention of breast deformities are playing an important role in surgical procedures. Currently the main form of breast cancer surgery is breast-conserving surgery (BCS), and even if mastectomy (MAS) is required, oncoplastic surgery and reconstruction options can improve outcomes, including health-related quality of life (QoL) of cancer patients. The purpose of this study was to assess whether surgery options induce different outcomes in self-reported QoL in guide-line treated breast cancer patients of the Network Oncology (NO).

Methods

This prospective Real-World-Data (RWD) study was conducted using data from the NO-clinical registry. QoL was assessed by evaluation of the European Organization of Research and Treatment Health-Related Quality of Life Core Questionnaire scale (EORTC QLQ-C30). Association factors between type of surgery options, without or with immediate breast reconstructions the EORTC QLQ-C30-scales at baseline after surgery, 6, 12, and 24 months later were analyzed with adjusted multivariate regression analysis, considering age, cancer stage, and treatment regimens, using software R.

Results

A total of 623 primary breast cancer patients (all tumor stages, median age 58 (ICR: 50–68) diagnosed and guide-line treated between 2013 and 2021), 524 BCS and 99 MAS, 24 of whom received immediate breast reconstruction (MBR), were eligible for analyses. Compared with BCS patients, MBR patients self-reported considerably lower global health, physical and social functioning, and higher burden of pain and financial difficulties at baseline. In later follow-up surveys, functional scales increased and symptoms decreased in all patients, and the differences between MAS and BCS equalized. Longitudinal analyses after 24 months were obtained from 258 patients and revealed that compared to 224 BCS, the 34 MAS patients reported increased social functioning (p = 0.04).

Conclusions

At 24 months after MAS, breast cancer patients' QoL improved compared with BCS, although impairments in QoL were reported immediately after MAS. A growing expertise in surgical procedures as well as supportive care is critical to optimizing patients' well-being. These findings may be considered when counseling breast cancer patients pre- and post-surgery.

Trial registration number

DRKS00013335 on 27/11/2017 retrospectively registered.

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Data availability

The datasets that support the findings in this article are not publicly available due to reasonable privacy and security concerns but are available from the corresponding authors upon reasonable request.

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Acknowledgements

We would like to thank all medical documentation officers of the NO consortium involved in the present work.

Funding

The NO was partially funded by Iscador AG Arlesheim, Switzerland, Abnoba GmbH Pforzheim, Germany, and Helixor Heilmittel GmbH Rosenfels, Germany. By contract, researchers were independent from the funder.

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Authors and Affiliations

  1. Research Institut Havelhöhe gGmbH at, Hospital Gemeinschaftskrankenhaus Havelhöhe, Kladower Damm 221, 14089, Berlin, Germany

    Shiao Li Oei, Anja Thronicke & Friedemann Schad

  2. Department of Plastic Surgery and Hand Surgery, Hospital Gemeinschaftskrankenhaus Havelhöhe, Kladower Damm 221, 14089, Berlin, Germany

    Gerrit Grieb

  3. Interdisciplinary Oncology and Supportive Cancer Medicine, Hospital Gemeinschaftskrankenhaus Havelhöhe, Kladower Damm 221, 14089, Berlin, Germany

    Friedemann Schad

  4. Breast Cancer Centre, Hospital Gemeinschaftskrankenhaus Havelhöhe, Kladower Damm 221, 14089, Berlin, Germany

    Jessica Groß

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  1. Shiao Li Oei
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  4. Friedemann Schad
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Contributions

All authors contributed to the study conception and design. Data collection and analysis were performed by SLO. The first draft of the manuscript was written by SLO and all authors commented on previous versions of the manuscript and read and approved the final manuscript.

Corresponding author

Correspondence to Shiao Li Oei.

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Conflict of interest

FS reports grants from Helixor Heilmittel GmbH (travel costs and honoraria for speaking), grants from AstraZeneca (travel costs and honoraria for speaking), grants from Abnoba GmbH, and grants from Iscador AG, outside the submitted work. JG reports grants from Roche, Siemens, mte, and Celgene (travel costs and honoraria for speaking), outside the submitted work. The other authors have declared that no competing interests exist. No payment was received for any other aspects of the submitted work. There are no patents, products in development or marketed products to declare. There are no other relationships/conditions/circumstances that present a potential conflict of interest.

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Oei, S.L., Thronicke, A., Grieb, G. et al. Evaluation of quality of life in breast cancer patients who underwent breast-conserving surgery or mastectomy using real-world data. Breast Cancer 30, 1008–1017 (2023). https://doi.org/10.1007/s12282-023-01494-x

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  • DOI: https://doi.org/10.1007/s12282-023-01494-x

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