title: Effect of cosmetic outcome on quality of life after breast cancer surgery.
abstract: OBJECTIVE
  Studies regarding the effects of aesthetic outcomes after breast cancer surgery on quality of life (QoL) have yielded inconsistent results. This study analyzed the aesthetic outcomes and QoL of women who underwent breast conserving surgery (BCS) or total mastectomy with immediate reconstruction (TMIR) using objective and validated methods.
  
  
  METHODS
  QoL questionnaires (EORTC QLQ-C30, BR23, and HADs) were administered at least 1 year after surgery and adjuvant therapy to 485 patients who underwent BCS, 46 who underwent TMIR, and 87 who underwent total mastectomy (TM) without reconstruction. Aesthetic results were evaluated using BCCT.core software and by a panel of physicians. Patients' body image perception was assessed using the body image scale (BIS).
  
  
  RESULTS
  QoL outcomes, including for social and role functioning, fatigue, pain, body image, and arm symptoms, were significantly better in the BCS and TMIR groups than in the TM group (p<0.05 each). BIS was significantly better in the BCS than in the TM or TMIR group (p<0.001 each). In the BCS and TMIR groups, general QoL factors were not significantly associated with objective cosmetic outcomes, except for body image in the QLQ-BR23. In contrast, patients with poorer BIS score reported lower QoL in almost all items of the QLQ-C30, BR23, and HADS (p<0.05 each).
  
  
  CONCLUSIONS
  In conclusion, BCS and TMIR enhanced QoL compared with TM. Among BCS and TMIR patients, objectively measured cosmetic results did not affect general QoL. Self-perception of body image seems to be more important for QoL after breast cancer surgery.
authors.affiliation: Department of Surgery, Seoul National University College of Medicine, Seoul, Republic of Korea.
authors.forename: M K
authors.initials: MK
authors.lastname: Kim
authors.affiliation: Department of Surgery, Gachon University Gil Medical Center, Incheon, Republic of Korea.
authors.forename: T
authors.initials: T
authors.lastname: Kim
authors.affiliation: Department of Surgery, Seoul National University College of Medicine, Seoul, Republic of Korea.
authors.forename: H G
authors.initials: HG
authors.lastname: Moon
authors.affiliation: Department of Plastic Surgery, Seoul National University College of Medicine, Seoul, Republic of Korea.
authors.forename: U S
authors.initials: US
authors.lastname: Jin
authors.affiliation: Department of Radiation Oncology, Seoul National University College of Medicine, Seoul, Republic of Korea.
authors.forename: K
authors.initials: K
authors.lastname: Kim
authors.affiliation: Department of Surgery, ASAN Medical Center, Seoul, Republic of Korea.
authors.forename: J
authors.initials: J
authors.lastname: Kim
authors.affiliation: Department of Surgery, Ewha Womans University Medical Center, Seoul, Republic of Korea.
authors.forename: J W
authors.initials: JW
authors.lastname: Lee
authors.affiliation: Department of Surgery, Seoul National University College of Medicine, Seoul, Republic of Korea.
authors.forename: J
authors.initials: J
authors.lastname: Kim
authors.affiliation: Department of Surgery, Seoul National University College of Medicine, Seoul, Republic of Korea.
authors.forename: E
authors.initials: E
authors.lastname: Lee
authors.affiliation: Department of Surgery, Seoul National University College of Medicine, Seoul, Republic of Korea.
authors.forename: T K
authors.initials: TK
authors.lastname: Yoo
authors.affiliation: Department of Surgery, Seoul National University College of Medicine, Seoul, Republic of Korea; Cancer Research Institute, Seoul National University, Seoul, Republic of Korea.
authors.forename: D-Y
authors.initials: DY
authors.lastname: Noh
authors.affiliation: Department of Plastic Surgery, Seoul National University College of Medicine, Seoul, Republic of Korea.
authors.forename: K W
authors.initials: KW
authors.lastname: Minn
authors.affiliation: Department of Surgery, Seoul National University College of Medicine, Seoul, Republic of Korea; Cancer Research Institute, Seoul National University, Seoul, Republic of Korea. Electronic address: hanw@snu.ac.kr.
authors.forename: W
authors.initials: W
authors.lastname: Han
mesh_terms: D000328:Adult; D001828:Body Image / Q000523:psychology*; D001943:Breast Neoplasms / Q000523:psychology / Q000601:surgery*; D005260:Female; D006801:Humans; D016462:Mammaplasty / Q000379:methods* / Q000523:psychology; D015412:Mastectomy, Segmental / Q000379:methods* / Q000523:psychology; D015413:Mastectomy, Simple / Q000379:methods* / Q000523:psychology; D008875:Middle Aged; D017060:Patient Satisfaction; D011788:Quality of Life / Q000523:psychology*; D016896:Treatment Outcome
keywords: BCCT.core; Body Image Scale; Breast cancer; Cosmetic result; Quality of life