Wu Tzu-Yi, Chang Tsai-Wang, Chang Sheng-Mao, Lin Yun-Ying, Wang Jung-Der, Kuo Yao-Lung
Department of Occupational Therapy, College of Medical and Health Science, Asia University, Taichung, Taiwan.
Division of Breast Surgery, Department of Surgery, Tainan Municipal An-Nan Hospital - China Medical University, Tainan, Taiwan.
Cancer Manag Res. 2019 Dec 17;11:10563-10571. doi: 10.2147/CMAR.S223314. eCollection 2019.
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.
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.
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.
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.
乳腺癌患者身体意象和生活质量(QoL)的动态变化尚未得到普遍研究。我们旨在比较保乳手术或全乳切除术后5至10年内乳腺癌幸存者生活质量和身体意象的动态变化。
邀请接受手术的非转移性乳腺癌患者在术后10年内完成世界卫生组织生活质量简表(WHOQOL-BREF)问卷和身体意象量表(BIS)。我们应用核平滑方法来捕捉患者术后5年内生活质量和身体意象的动态变化。我们还构建了多元线性回归模型,以确定生活质量和身体意象的预测因素。
共收集了581例患者,其中211例接受了保乳手术。保乳手术与全乳切除术在生活质量和身体意象方面无统计学显著差异,但前者呈波动趋势。在多元线性回归模型中,BIS是WHOQOL-BREF中每个项目和领域的预测指标,并解释了随时间动态变化的趋势。未进行淋巴结清扫的患者似乎积极感受较少,但对性活动更满意。
身体意象可预测乳腺癌患者的生活质量。身体意象和生活质量的动态变化对乳腺癌患者手术的共同决策有用。