Tarkowska Magdalena, Głowacka-Mrotek Iwona, Nowikiewicz Tomasz, Goch Aleksander, Zegarski Wojciech
Department of Physiotherapy, Nicolaus Copernicus University in Toruń, Collegium Medicum in Bydgoszcz, 85-094 Bydgoszcz, Poland.
Department of Rehabilitation, Nicolaus Copernicus University in Toruń, Collegium Medicum in Bydgoszcz, 85-094 Bydgoszcz, Poland.
J Clin Med. 2021 Mar 24;10(7):1339. doi: 10.3390/jcm10071339.
The aim of this study was to evaluate the quality of life of patients undergoing surgical treatment of breast cancer depending on the type of procedure involving the breast (mastectomy vs. breast conserving treatment) and axillary fossa (sentinel lymph node biopsy vs. axillary lymph node dissection). The prospective study was carried out in a group of 338 females undergoing breast cancer treatment. Study variables were assessed by means of a diagnostic survey using standardized QLQ C30 and BR23 questionnaires as well as the Acceptance of Illness Scale and Mini-MAC scales. The quality of life was assessed at threetime points: on the day before the surgical procedure (I assessment) as well as three and 12 months after surgery (II and III assessment). Statistically significant differences between study groups were observed in the overall quality of life subscale (I, II, III- < 0.0001), physical functioning (I- < 0.0001; II- = 0.0413; III- < 0.0001), role functioning (I- = 0.0002; III- < 0.0001), emotional functioning (III- = 0.0082), cognitive functioning (I- = 0.0112; III- < 0.0001), social functioning (III- < 0.0001), body image (I, II, III- < 0.0001), and sexual functioning (I- = 0.0233; III- = 0.0011). In most symptomatic scales, significant ( < 0.05) differences were also noted. Mastectomy and limfadenectomy patients were significantly ( < 0.0001) more prone to present with destructive coping strategies one year after surgery. Breast conserving therapy is associated with better quality of life outcomes as compared to mastectomy. Sentinel lymph node biopsy is associated with a lower intensity of adverse changes in multiple dimensions of patients' functioning.
本研究的目的是根据涉及乳房的手术类型（乳房切除术与保乳治疗）和腋窝（前哨淋巴结活检与腋窝淋巴结清扫术）来评估接受乳腺癌手术治疗患者的生活质量。这项前瞻性研究在一组338名接受乳腺癌治疗的女性中进行。通过使用标准化的QLQ C30和BR23问卷以及疾病接受量表和Mini-MAC量表的诊断性调查来评估研究变量。在三个时间点评估生活质量：手术前一天（I评估）以及手术后三个月和十二个月（II和III评估）。研究组之间在总体生活质量子量表（I、II、III - <0.0001）、身体功能（I - <0.0001；II - =0.0413；III - <0.0001）、角色功能（I - =0.0002；III - <0.0001）、情绪功能（III - =0.0082）、认知功能（I - =0.0112；III - <0.0001）、社会功能（III - <0.0001）、身体形象（I、II、III - <0.0001）和性功能（I - =0.0233；III - =0.0011）方面观察到统计学上的显著差异。在大多数症状量表中，也注意到显著（<0.05）差异。乳房切除术和淋巴结清扫术患者在术后一年明显（<0.0001）更倾向于采用消极应对策略。与乳房切除术相比，保乳治疗与更好的生活质量结果相关。前哨淋巴结活检与患者功能多个维度的不良变化强度较低相关。
