Quality of life in patients with recurrent breast cancer after second breast-conserving therapy in comparison with mastectomy: the German experience.
BACKGROUND
Although some studies suggest that breast-conserving therapy (BCT) shows better psychosocial outcomes than mastectomy in patients with primary breast cancer, little is known about the outcomes of these surgical options in recurrent breast cancer. We investigated differences in overall survival and re-recurrence rates as well as psychosocial outcomes among patients who underwent BCT or mastectomy after the diagnosis of recurrent breast cancer in a single-center setting.


METHODS
124 of 186 eligible patients who underwent surgical treatment for breast cancer recurrence completed the questionnaires on quality of life (EORTC QLQ-C30 and -BR23), fear of progression (PA-F-KF), anxiety and depression (HADS), and body image (BIS).


RESULTS
Women after breast-conserving surgery (n = 46) showed significantly better outcomes than women after mastectomy (n = 61) with respect to body image (P < 0.001 in BIS and p < 0.001 in BR23), social functioning (p = 0.016), emotional functioning (p = 0.028), and role functioning (p = 0.043). There were no significant group differences regarding anxiety, depression, and fear of progression as well as re-recurrence and survival rates. Predictors of good quality of life were partnership (OR 2.46), higher monthly family income (OR 3.54), and higher professional qualification (OR 4.3) in our group of patients.


CONCLUSIONS
Our results indicate that patients treated with breast-conserving therapy after recurrent breast cancer perceive lower impairments in body image and several aspects of quality of life than patients treated with mastectomy.
Department of Gynecology, University Medical Center, Martinistraße 52, 20246, Hamburg, Germany.
Svenja
S
Jendrian
Department of Gynecology, University Medical Center, Martinistraße 52, 20246, Hamburg, Germany.
Katharina
K
Steffens
Department of Gynecology, University Medical Center, Martinistraße 52, 20246, Hamburg, Germany.
Barbara
B
Schmalfeldt
Department of Gynecology, University Medical Center, Martinistraße 52, 20246, Hamburg, Germany.
Elena
E
Laakmann
Institute for Medical Psychology, University Medical Center Hamburg, Hamburg, Germany.
Corinna
C
Bergelt
Department of Gynecology, University Medical Center, Martinistraße 52, 20246, Hamburg, Germany. iwitzel@uke.de.
Isabell
I
Witzel
D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000473:pathology / Q000523:psychology / Q000601:surgery*; D005260:Female; D005858:Germany; D006801:Humans; D016462:Mammaplasty; D008408:Mastectomy / Q000009:adverse effects / Q000523:psychology*; D015412:Mastectomy, Segmental / Q000523:psychology*; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology / Q000523:psychology / Q000601:surgery*; D011788:Quality of Life / Q000523:psychology
Breast cancer; Breast-conserving therapy; Mastectomy; Overall survival; Quality of life