Cosmetic outcome and quality of life are inextricably linked in breast-conserving therapy
José H. Volders MD
Department of Surgical Oncology, VU University Medical Center, Amsterdam, The Netherlands
Search for more papers by this authorVera L. Negenborn MD
Department of Plastic Surgery, VU University Medical Center, Amsterdam, The Netherlands
Search for more papers by this authorMax H. Haloua PhD
Department of Surgical Oncology, VU University Medical Center, Amsterdam, The Netherlands
Search for more papers by this authorNicole M. A. Krekel PhD
Department of Plastic Surgery, VU University Medical Center, Amsterdam, The Netherlands
Search for more papers by this authorKatarzyna Jóźwiak PhD
Department of Epidemiology and Biostatistics, NKI-AVL, Amsterdam, The Netherlands
Search for more papers by this authorSybren Meijer PhD
Department of Plastic Surgery, VU University Medical Center, Amsterdam, The Netherlands
Search for more papers by this authorCorresponding Author
Petrousjka M. van den Tol PhD
Department of Plastic Surgery, VU University Medical Center, Amsterdam, The Netherlands
Correspondence
M. Petrousjka van den Tol, PhD, Department of Surgical Oncology, VU University Medical Center, De Boelelaan 1117, Room 7F-027, 1081 HV Amsterdam, the Netherlands.
Email: [email protected]
Search for more papers by this authorJosé H. Volders MD
Department of Surgical Oncology, VU University Medical Center, Amsterdam, The Netherlands
Search for more papers by this authorVera L. Negenborn MD
Department of Plastic Surgery, VU University Medical Center, Amsterdam, The Netherlands
Search for more papers by this authorMax H. Haloua PhD
Department of Surgical Oncology, VU University Medical Center, Amsterdam, The Netherlands
Search for more papers by this authorNicole M. A. Krekel PhD
Department of Plastic Surgery, VU University Medical Center, Amsterdam, The Netherlands
Search for more papers by this authorKatarzyna Jóźwiak PhD
Department of Epidemiology and Biostatistics, NKI-AVL, Amsterdam, The Netherlands
Search for more papers by this authorSybren Meijer PhD
Department of Plastic Surgery, VU University Medical Center, Amsterdam, The Netherlands
Search for more papers by this authorCorresponding Author
Petrousjka M. van den Tol PhD
Department of Plastic Surgery, VU University Medical Center, Amsterdam, The Netherlands
Correspondence
M. Petrousjka van den Tol, PhD, Department of Surgical Oncology, VU University Medical Center, De Boelelaan 1117, Room 7F-027, 1081 HV Amsterdam, the Netherlands.
Email: [email protected]
Search for more papers by this authorAbstract
Introduction
Cosmetic results and quality of life (QoL) are increasingly important in the treatment of breast cancer. This study was designed to determine the relationship between QoL and both subjectively and objectively measured cosmetic outcomes of breast-conserving therapy (BCT), and its course over time.
Methods
A total of 128 breast cancer patients who underwent BCT as part of a prospective randomized controlled trial were included. QoL was measured using the EORTC QLQ-C30 and QLQ-BR23 at baseline, 3, 6, 12, and 36 months. Cosmetic outcome was determined by patient self-evaluation, panel evaluation, and BCCT.core software.
Results
By 36 months, all QoL factors except arm symptoms had returned to baseline or improved. After adjustment for patient and tumor characteristics, a significantly better QoL in terms of body image, pain, and arm and breast symptoms was found for good/excellent cosmetic outcomes compared to fair/poor outcomes, as measured by both patient self-evaluation and panel evaluation. The BCCT.core showed no correlation with any QoL factors.
Conclusion
There is a high correlation between poor cosmetic outcome and low scores on quality of life indicators, underlining the importance of achieving a good cosmetic outcome after BCT.
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