Pandey Manoj, Thomas Bejoy C, Ramdas Kunnambath, Ratheesan Kuttan
Department of Surgical Oncology, Regional Cancer Centre, Kerala, India.
Jpn J Clin Oncol. 2006 Jul;36(7):468-72. doi: 10.1093/jjco/hyl065.
Quality of life (QOL) after a diagnosis of breast cancer varies considerably across individuals. The treatment modality of the patients significantly contributes to their QOL. The present study reports the initial findings on the early effects of surgery in patients with breast cancer.
Two hundred and fifty-one women with breast cancer undergoing surgery were interviewed prior to and after the surgery using the Functional Assessment of Cancer Therapy for Breast (FACT-B). Trial Outcome Index (TOI) was calculated besides total and subscale scores. The results were analyzed using paired t-test and two-sample paired Wilcoxon signed rank test. Multivariate analysis was carried out using repeated measures general liner model with 2-way interactions.
Significant reduction in physical well-being (P = 0.001), functional well-being (P = 0.00) and the breast-specific subscale (P = 0.000) was observed after surgery. No significant change was observed in social or emotional well-being. Total FACT scores and TOI too showed significant declines (P = 0.000; and P = 0.000 respectively) on univariate analysis. Multivariate analysis, however, showed no difference in QOL after surgery, but QOL was significantly poor among women undergoing mastectomy.
Results of the present study indicate no significant change in overall QOL immediately after the surgery, probably reflecting strong family and social support for these women. QOL was significantly better among women undergoing breast conservation compared with mastectomy.
乳腺癌确诊后的生活质量(QOL)在个体间差异很大。患者的治疗方式对其生活质量有显著影响。本研究报告了乳腺癌患者手术早期效果的初步研究结果。
对251例接受手术的乳腺癌女性患者在手术前后使用乳腺癌治疗功能评估量表(FACT - B)进行访谈。除了计算总分和分量表得分外,还计算了试验结果指数(TOI)。结果采用配对t检验和双样本配对Wilcoxon符号秩检验进行分析。使用具有双向交互作用的重复测量一般线性模型进行多变量分析。
术后观察到身体幸福感(P = 0.001)、功能幸福感(P = 0.00)和乳腺特定分量表(P = 0.000)显著降低。社会或情感幸福感未观察到显著变化。单变量分析显示,FACT总分和TOI也显著下降(分别为P = 0.000;和P = 0.000)。然而,多变量分析显示术后生活质量无差异,但接受乳房切除术的女性生活质量显著较差。
本研究结果表明,手术后总体生活质量没有显著变化,这可能反映了这些女性获得了强大的家庭和社会支持。与乳房切除术相比,接受保乳手术的女性生活质量明显更好。