| Autor: |
Vrancken Peeters, N. J. M. C., Kaplan, Z. L. R., Clarijs, M. E., Mureau, M. A. M., Verhoef, C., van Dalen, T., Husson, O., Koppert, L. B. |
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Quality of Life Research; Feb2024, Vol. 33 Issue 2, p467-479, 13p |
| Abstrakt: |
Purpose: As life expectancy continues to rise, post-treatment health-related quality of life (HRQoL) of breast cancer patients becomes increasingly important. This study examined the one-year longitudinal relation between axillary treatments and physical, psychosocial, and sexual wellbeing and arm symptoms. Methods: Women diagnosed with breast cancer who received different axillary treatments being axilla preserving surgery (APS) with or without axillary radiotherapy or full axillary lymph node dissection (ALND) with or without axillary radiotherapy were included. HRQoL was assessed at baseline, 6- and 12-months postoperatively using the BREAST-Q and the European Organization for Research and Treatment of Cancer QoL Questionnaire Breast Cancer Module (EORTC QLQ-BR23). Mixed regression models were constructed to assess the impact of axillary treatment on HRQoL. HRQoL at baseline was compared to HRQoL at 6- and at 12-months postoperatively. Results: In total, 552 patients were included in the mixed regressions models. Except for ALND with axillary radiotherapy, no significant differences in physical and psychosocial wellbeing were found. Physical wellbeing decreased significantly between baseline and 6- and 12-months postoperatively (p < 0.001, p = 0.035) and psychosocial wellbeing decreased significantly between baseline and 12 months postoperatively (p = 0.028) for ALND with axillary radiotherapy compared to APS alone. Arm symptoms increased significantly between baseline and 6 months and between baseline and 12 months postoperatively for APS with radiotherapy (12.71, 13.73) and for ALND with radiotherapy (13.93, 16.14), with the lowest increase in arm symptoms for ALND without radiotherapy (6.85, 7.66), compared to APS alone (p < 0.05). Conclusion: Physical and psychosocial wellbeing decreased significantly for ALND with radiotherapy compared to APS alone. Shared decision making and expectation management pre-treatment could be strengthened by discussing arm symptoms per axillary treatment with the patient. Plain English summary: Breast cancer is one of the most common cancers among women worldwide. Since the survival rates are improving, the health-related quality of life of breast cancer patients after treatment becomes more important. One of the most important factors in the prognosis of breast cancer patients is the presence of axillary metastasis, the spread of breast cancer to lymph nodes in the armpit. There are different axillary treatments which can all affect health-related quality of life negatively. Therefore, the aim of this study is to examine the effect of different axillary treatments on physical, psychosocial, and sexual wellbeing and arm symptoms of breast cancer patients. This study included women with breast cancer who received either axillary preserving surgery with or without axillary radiotherapy, or a full axillary lymph node dissection with or without axillary radiotherapy. health-related quality of life was assessed with validated breast cancer specific questionnaires at baseline, 6- and 12-months postoperatively. Patients who underwent axilla preserving surgery without axillary radiotherapy experienced significantly less decline in both physical and psychosocial wellbeing as well as significantly fewer increase in arm symptoms compared to patients who received the more extensive axillary treatments. The results of this study can be used to improve shared decision making and expectation management for future breast cancer patients.b [ABSTRACT FROM AUTHOR] |
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Complementary Index |
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Full text from SpringerLink