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Breast Cancer Research and Treatment
Published in: Breast Cancer Research and Treatment 2/2020

Open Access 01-01-2020 | Mastectomy | Epidemiology

Patient-reported cosmetic satisfaction and the long-term association with quality of life in irradiated breast cancer patients

Authors: M. C. T. Batenburg, M. L. Gregorowitsch, W. Maarse, A. Witkamp, D. A. Young-Afat, A. Braakenburg, A. Doeksen, T. van Dalen, M. Sier, E. J. P. Schoenmaeckers, C. H. van Gils, H. J. G. D. van den Bongard, H. M. Verkooijen, the UMBRELLA study group

Published in: Breast Cancer Research and Treatment | Issue 2/2020

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Abstract

Purpose

To evaluate patient-reported cosmetic satisfaction in women treated with radiation therapy for breast cancer and to determine the association between dissatisfaction and quality of life (QoL) and depression.

Methods

Within the prospective UMBRELLA breast cancer cohort, all patients ≥ 1 year after breast conserving treatment or mastectomy with immediate reconstruction were selected. Self-reported cosmetic satisfaction was measured on a 5-point Likert scale. QoL, social functioning, and emotional functioning were measured using EORTC QLQ-C30 and BR23 at 1, 2, and 3 years after inclusion. Mixed model analysis was performed to assess the difference in different domains of QoL between patients with good versus poor self-reported cosmetic satisfaction over time after adjustment for potential confounders. Depression scores were collected by means of the HADS-NL questionnaire. Chi-square test or Fisher's exact test was used to assess the difference in proportions of HADS score ≥ 8, indicating increased depression risk, between satisfied and dissatisfied patients.

Results

808 patients were selected for analysis. Respectively one, two, and three years after surgery, 8% (63/808), 7% (45/626), and 8% (31/409) of patients were dissatisfied with their cosmetic outcome. Poor patient-reported cosmetic satisfaction was independently associated with impaired QoL, body image, and lower emotional and social functioning. Scores ≥ 8 on the HADS depression subscale were significantly more common in dissatisfied patients.

Conclusions

Dissatisfaction with cosmetic outcome was low after breast cancer surgery followed by radiation therapy during 3 years follow-up. Knowing the association between dissatisfaction with cosmetic outcome and QoL and depression could help to improve the preoperative counseling of breast cancer patients.
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Metadata
Title
Patient-reported cosmetic satisfaction and the long-term association with quality of life in irradiated breast cancer patients
Authors
M. C. T. Batenburg
M. L. Gregorowitsch
W. Maarse
A. Witkamp
D. A. Young-Afat
A. Braakenburg
A. Doeksen
T. van Dalen
M. Sier
E. J. P. Schoenmaeckers
C. H. van Gils
H. J. G. D. van den Bongard
H. M. Verkooijen
the UMBRELLA study group
Publication date
01-01-2020
Publisher
Springer US
Published in
Breast Cancer Research and Treatment / Issue 2/2020
Print ISSN: 0167-6806
Electronic ISSN: 1573-7217
DOI
https://doi.org/10.1007/s10549-019-05470-y

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