title: Comparison of early quality of life in patients treated with radiotherapy following mastectomy or breast conservation therapy: a prospective study.
abstract: BACKGROUND
  To compare quality of life (QOL) in breast cancer patients from a developing country after breast conservation surgery (BCS) or mastectomy and adjuvant radiotherapy (RT).
  
  
  METHODS
  In a 6-month period, all consecutive early and locally advanced breast cancer patients treated with either BCS or mastectomy and treated with RT were analyzed. All patients who underwent mastectomy were treated with 45 Gray/20#/4 weeks. Patients with BCS were treated with a dose of 45-50 Gray/25#/5 weeks to whole breast followed by tumor bed boost (15 Gray/6#/6 days with suitable energy electrons). Prospective evaluation of QOL using EORTC QLQ C30 and breast cancer specific QLQ BR23 was done before starting RT (baseline), at mid-RT and at RT conclusion for all patients.
  
  
  RESULTS
  One hundred and thirteen patients had mastectomy and 142 patients underwent BCS. Reliability test (Cronbach alpha) for questionnaire filling was 0.669-0.886. At pre-RT assessment, global QOL scores in mastectomy and BCS groups were 71.1 and 71.3, respectively. There was no significant difference in pre-RT EORTC QLQ C30 functional and symptom domains between mastectomy and BCS patients. However, social function domain score was higher in patients who underwent mastectomy (83 versus 73.9; p=0.018). In QLQ BR23 domains, body image and sexual functioning domains were similar between the two groups. However, sexual enjoyment (10.9 versus 47.6; p=0.006) and future perspective (7.4 versus 37.1; p=0.036) domains were significantly better in BCS arm. There was no difference between systemic side effect (BRSSE), breast symptom (BRBS) and arm symptom (BRAS) domain scores between the groups. There was no significant difference in change of QOL scores between mastectomy and BCS patients at RT completion as compared to baseline.
  
  
  CONCLUSIONS
  There was no significant difference in quality of life in patients with BCS versus those with mastectomy. However, patients who underwent BCS had better sexual enjoyment and future perspective scores compared with mastectomy patients. There was no significant change of QOL domain scores after RT in mastectomy and BCS patients.
authors.affiliation: Department of Radiation Oncology, Tata Memorial Hospital, Parel, Mumbai, India. anusheel8@hotmail.com
authors.forename: Anusheel
authors.initials: A
authors.lastname: Munshi
authors.forename: Debnarayan
authors.initials: D
authors.lastname: Dutta
authors.forename: Sajal
authors.initials: S
authors.lastname: Kakkar
authors.forename: Ashwini
authors.initials: A
authors.lastname: Budrukkar
authors.forename: Rakesh
authors.initials: R
authors.lastname: Jalali
authors.forename: Rajiv
authors.initials: R
authors.lastname: Sarin
authors.forename: Sudeep
authors.initials: S
authors.lastname: Gupta
authors.forename: Vani
authors.initials: V
authors.lastname: Parmar
authors.forename: Rajendra
authors.initials: R
authors.lastname: Badwe
mesh_terms: D001943:Breast Neoplasms / Q000532:radiotherapy / Q000601:surgery; D003906:Developing Countries; D005260:Female; D006801:Humans; D007194:India; D008408:Mastectomy / Q000706:statistics & numerical data; D015412:Mastectomy, Segmental / Q000706:statistics & numerical data; D011788:Quality of Life; D011795:Surveys and Questionnaires; D013997:Time Factors