Tzu-Yi Wu,1 Tsai-Wang Chang,2 Sheng-Mao Chang,3 Yun-Ying Lin,4 Jung-Der Wang,5,6 Yao-Lung Kuo7
1Department of Occupational Therapy, College of Medical and Health Science, Asia University, Taichung, Taiwan; 2Division of Breast Surgery, Department of Surgery, Tainan Municipal An-Nan Hospital – China Medical University, Tainan, Taiwan; 3Department of Statistics, National Cheng Kung University, Tainan, Taiwan; 4Department of Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan; 5Departments of Internal Medicine and Occupational and Environmental Medicine, National Cheng Kung University Hospital, Tainan, Taiwan; 6Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan; 7Department of Surgery, National Cheng-Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan and Dou-Liou, Taiwan
Correspondence: Yao-Lung Kuo
Department of Surgery, National Cheng-Kung University Hospital, College of Medicine, National Cheng Kung University, No.138, Sheng Li Road, Tainan 704, Taiwan
Tel +886-6-2353535 ext. 5224
Email ylkuo@mail.ncku.edu.tw
Purpose: Dynamic changes of body image and quality of life (QoL) in breast cancer patients were not commonly investigated. We aimed to compare the dynamic changes in QoL and body image of breast cancer survivors receiving breast-conserving surgery or total mastectomy within 5–10 years after surgery.
Methods: Patients with non-metastatic breast cancer who received surgery were invited to complete the World Health Organization Quality of Life–Brief (WHOQOL-BREF) questionnaire and the Body Image Scale (BIS) within 10 years after surgery. We applied kernel smoothing methods to capture the dynamic changes of the patients’ QoL and body image within 5 years after surgery. We also constructed multiple linear regression models to identify predictive factors for QoL and body image.
Results: A total of 581 patients were collected, and 211 of them received breast-conserving surgery. There were no statistically significant differences in QoL and body image for breast-conserving surgery versus total mastectomy, but the former showed fluctuating trends. BIS was a predictor of every item and domain in the WHOQOL-BREF in the multiple linear regression model, and explanatory of the trends of dynamic change over time. Patients without lymph node dissection seemed to have less positive feelings but were more satisfied with sexual activities.
Conclusion: Body image is predictive of the QoL of breast cancer patients. Dynamic changes of body image and QoL would be useful for shared decision-making regarding surgery in breast cancer patients.
Keywords: breast cancer survivors, body image, breast-conserving surgery, quality of life, total mastectomy
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