Long-Term QOL Examined for Surgical Choices in Breast Cancer

Psychosocial, sexual well-being worse with mastectomy and reconstruction without RT versus breast-conserving surgery with RT

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WEDNESDAY, April 13, 2022 (HealthDay News) -- Among women receiving treatment for early-stage breast cancer, mastectomy and reconstruction without radiation therapy (RT) is associated with similar breast satisfaction and physical well-being, but worse psychosocial and sexual well-being compared with breast-conserving surgery with RT, according to a study published online April 13 in JAMA Surgery.

Summer E. Hanson, M.D., Ph.D., from the University of Texas MD Anderson Cancer Center in Houston, and colleagues examined the association of treatment with breast-conserving surgery with RT versus mastectomy and reconstruction without RT with long-term quality of life among women diagnosed with stage 0 to II breast cancer. A total of 647 patients responded to a survey at a median of 10.3 years from diagnosis; 551 patients confirmed treatment with breast-conserving surgery with RT (315 patients) and mastectomy and reconstruction without RT (236 patients).

The researchers observed no significant difference in satisfaction with breasts or physical well-being for breast-conserving surgery with RT and mastectomy and reconstruction without RT. In contrast, significantly worse psychological well-being and sexual well-being were seen for mastectomy and reconstruction without RT. There was no difference between the groups in health utility and decisional regret.

"To build on a core finding of the study by Hanson et al, more work must be done to understand and address disparities in quality of life outcomes after breast cancer surgery for minoritized patients and patients of lower socioeconomic status," write the authors of an accompanying editorial.

Several authors disclosed financial ties to industry.

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