Impact of conservative, radical, and oncoplastic surgery on the quality of life of women with breast cancer
DOI:
https://doi.org/10.29289/2594539420250020%20Keywords:
breast cancer, health-related quality of life, oncoplastic surgery, chemotherapy, patient-centered careAbstract
Introduction: Health-related quality of life (HRQoL) has become a key outcome in evaluating breast cancer patients, influencing treatment decisions and long-term prognosis. Different surgical approaches and adjuvant therapies may significantly impact various HRQoL domains, including physical, emotional, and social well-being. This study aimed to assess HRQoL in public sector employees undergoing surgical treatment for breast cancer, comparing different surgical approaches (conservative, radical, and oncoplastic) and analyzing the impact of chemotherapy and radiotherapy on HRQoL outcomes. Methods: This was a cross-sectional, observational study conducted at Hospital do Servidor Público Estadual de São Paulo (HSPE) between 2021 and 2024. A total of 600 female patients diagnosed with non-metastatic breast cancer who underwent surgical treatment were included. HRQoL was assessed using the validated EORTC QLQ-C30 and QLQ-BR23 questionnaires. Statistical analyses included ANOVA and multivariate regression models, adjusting for confounding variables. Results: Patients who underwent conservative surgery had significantly better HRQoL scores compared to those undergoing oncoplastic or radical surgery. Surprisingly, oncoplastic surgery was associated with lower global HRQoL (β=-16.27; p=0.003), cognitive function (β=-22.34; p<0.001), and social function (β=-19.15; p<0.001). Chemotherapy was linked to persistent cognitive impairment and increased systemic side effects. The mean body image score was highest in the conservative surgery group (80.9) compared to mastectomy (45.8; p=0.003). Common symptoms included fatigue, pain, and insomnia. Conclusions: Surgical approach plays a crucial role in HRQoL outcomes for breast cancer patients. Contrary to expectations, oncoplastic techniques were associated with worse quality of life scores, highlighting the need for personalized treatment decisions. Chemotherapy had a significant negative impact on cognitive function and symptom burden. These findings emphasize the importance of incorporating HRQoL assessments in clinical practice to optimize patient-centered treatment strategies and postoperative rehabilitation.
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Copyright (c) 2026 Marcelo Antonini, Mylena Scheneider Becale, Arthur Gaia Duarte Peixoto, André Mattar, Francisco Pimentel Cavalcante, Felipe Zerwes, Eduardo de Camargo Millen, Fabricio Palermo Brenelli, Antonio Luiz Frasson, Odair Ferraro
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