Impact Of Breast Conserving Surgery Choice On Breast Cancer Patients' Quality Of Life Change During Radiotherapy

Purpose:To investigate the impact of breast conserving surgery(BCS)choice on breast cancer patients' Quality of Life(QoL)change during postoperative radiotherapy(RT).Methods:All 145 women who had the first ever primary postoperative radiotherapy of breast cancer from July to December in 2015 at the Fourth Hospital of Hebei Medical University were identified for analysis.Among them 35 patients had BCS and others had mastectomy surgery(MAS).EORTC QLQ-C30(C30)and QLQ-BR23(BR23)questionnaire were used to assess the Qol before and after RT.According to their calculating rules of QoL domains the change of standard score during the RT were cited as the outcomes.The baseline variables of age,height,weight,education level,marital status,income level,menstrual status,disease history,tumor size,lymph nodes pathology stage,disease stage,preoperative and postoperative chemotherapy,endocrine therapy,molecular target treatment and radiotherapy field region were used as covariates in analysis.T-test were used for comparison of continuous variables between BCS and MAS patients along with statistics of mean and standard deviation.Chi-square test was conducted for percentage comparison for categorical variables.Multiple linear regressions were conducted to evaluate the effect of BCS and MAS on the QoL change.Two sides P value < 0.05 was regarded as the statistically significant.Statistical tool was SPSS 19.0.Results:Among BCS patients,QoL change over RT was statistically significant in sexual enjoyment and breast symptoms(P<0.05)domains only in BR23.The domains of physical functioning,emotional functioning,social functioning,fatigue,nausea and vomiting,pain,dyspnoea,insomnia,appetite loose,diarrhea,global health status were statistically significantly changed during radiotherapy in C30 and domains of body image,system therapy side effects,breast symptoms,arm symptoms and upset by hair loss in BR23 had statistically significant changes in MAS during RT(P < 0.05).Simple comparison of QoL change between two groups of patients showed the sexual enjoyment was statistically significant different only(P=0.02).The Multiple linear regression adjusted by the covariates(age,education level,income level,radiotherapy field region,disease stage,preoperative and postoperative chemotherapy)showed that all the QoL domains expect the constipation had no significant difference between two group of breast cancer patients(P=0.04).Further studies are expected.Conclusion:1.BCS patients appear to have increased sexual enjoyment and breast symptom scores of BR23.2.The majority QoL of MAS patients show the increased symptom score and decreased function score over RT patients,except role function,constipation,financial difficulties,sexual function,sexual enjoyment,future perspective.3.Compared with BCS patients,the MAS patients have the similar change of QoL measured in C30 and BR23 expect the constipation domain.