Arndt Volker, Stegmaier Christa, Ziegler Hartwig, Brenner Hermann
Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Bergheimer Strasse 20, 69115 Heidelberg, Germany.
J Cancer Res Clin Oncol. 2008 Dec;134(12):1311-8. doi: 10.1007/s00432-008-0418-y. Epub 2008 May 27.
Breast-conserving therapy (BCT) was developed to improve quality of life (QOL) in early stage breast cancer patients. Except for differences in body image, literature comparing the psychosocial sequelae of BCT with mastectomy is ambiguous and shows a lack of substantial benefits. However, knowledge regarding long term effects of treatment on QOL in breast cancer is very limited as most of the pertinent studies have been performed in the early post-operative period. Therefore we compared QOL in women with breast cancer undergoing BCT versus women undergoing mastectomy over a 5-year period following primary surgery.
QOL was assessed at 1, 3, and 5 years after diagnosis in a population based cohort of 315 women with early stage breast cancer (UICC stage I-II) from Saarland (Germany) using the EORTC QLQ-C30 questionnaire and the breast cancer specific module BR23.
Breast-conserving therapy was performed in 226 women (72%). After control for potential confounding, women with BCT reported better physical and role functioning, were sexually more active and more satisfied with their body image already at 1 year after diagnosis (all P values < 0.05). Differences in overall QOL and social functioning were gradually increasing over time and became statistically significant only at 5 years.
Whereas some, very specific benefits of BCT, such as a better body image, are already visible very timely after completion of therapy, benefits in broader measures such as psychosocial well-being and overall quality of life gradually increase over time and become fully apparent only in the long run.
保乳治疗（BCT）旨在提高早期乳腺癌患者的生活质量（QOL）。除了身体形象方面的差异外，比较BCT与乳房切除术心理社会后遗症的文献并不明确，且未显示出显著益处。然而，由于大多数相关研究是在术后早期进行的，关于治疗对乳腺癌患者生活质量的长期影响的知识非常有限。因此，我们比较了接受BCT的乳腺癌女性与接受乳房切除术的女性在初次手术后5年内的生活质量。
使用欧洲癌症研究与治疗组织（EORTC）QLQ-C30问卷和乳腺癌特异性模块BR23，对来自德国萨尔州的315名早期乳腺癌（国际抗癌联盟（UICC）I-II期）女性的人群队列在诊断后1年、3年和5年进行生活质量评估。
226名女性（72%）接受了保乳治疗。在控制潜在混杂因素后，接受BCT的女性在诊断后1年时报告身体和角色功能更好，性活动更活跃，对身体形象更满意（所有P值<0.05）。总体生活质量和社会功能的差异随时间逐渐增加，仅在5年时具有统计学意义。
虽然BCT的一些非常特定的益处，如更好的身体形象，在治疗完成后很快就可见，但在更广泛的衡量标准中，如心理社会幸福感和总体生活质量，益处会随着时间逐渐增加，并且只有从长远来看才会完全显现。
