Nair Es Revathy, Ghalige Hemanth S, Gopalaswamy Vinaya, Tukaram Arunkumar, Subbaramaiah Shwetha
Surgery, Employees' State Insurance Corporation Medical College (ESIC MC) and Post Graduate Institute of Medical Sciences and Research (PGIMSR), Bengaluru, IND.
Internal Medicine, Employees' State Insurance Corporation Medical College (ESIC MC) and Post Graduate Institute of Medical Sciences and Research (PGIMSR), Bengaluru, IND.
Cureus. 2025 Aug 13;17(8):e89999. doi: 10.7759/cureus.89999. eCollection 2025 Aug.
Introduction In India, breast cancer is often diagnosed at advanced stages, leading to a high proportion of patients undergoing modified radical mastectomy (MRM) as the primary surgical treatment. While effective, MRM is associated with significant long-term physical and psychosocial morbidity. This study aimed to assess the quality of life (QoL) of breast cancer survivors treated with MRM in a tertiary care center, utilizing the updated European Organisation for Research and Treatment of Cancer (EORTC) QLQ-BR42 questionnaire. Methods A cross-sectional observational study was conducted at the Employees' State Insurance Corporation Medical College (ESIC MC) and Post Graduate Institute of Medical Sciences and Research (PGIMSR), Bengaluru, from September 2024 to June 2025. A consecutive sample of 300 female breast cancer survivors who had undergone MRM and completed adjuvant therapy was recruited. Data were collected via face-to-face interviews using EORTC QLQ-BR42 modules. QoL scores were calculated and transformed to a 0-100 scale. Group comparisons were performed using independent t-tests and ANOVA to assess differences in QoL between patients who received single modality (adjuvant chemotherapy alone) and those who received dual modality (adjuvant chemotherapy and radiotherapy). Results A total of 300 participants were included, with a mean age of 52.4 ± 10.6 years. All had undergone MRM, with 66% (n = 198) receiving dual modality and 34% (n = 102) receiving single modality treatment. The study found high mean linearized scores for body image satisfaction (79.77 ± 8.99) and breast satisfaction (70.00 ± 8.50). However, the future perspective domain was moderately affected (62.00 ± 15.00). Symptom domains showed that breast symptoms (55.68 ± 24.90) and arm symptoms (24.77 ± 10.20) had the highest symptom burden. Sexual health was the most severely impaired aspect, with a mean score of 1.67 for sexual functioning and 0.00 for sexual enjoyment. No statistically significant differences in any QoL domain were observed between the single modality and dual modality treatment groups. Conclusions Our study suggests that breast cancer survivors treated with MRM in this cohort report a high degree of satisfaction with their body image but suffer from significant physical symptoms and severely impaired sexual health. The addition of radiotherapy does not appear to significantly impact long-term QoL. The study underscores the need for comprehensive, culturally sensitive, and resource-appropriate supportive care, particularly focusing on sexual health and symptom management, to improve the holistic well-being of these survivors.
引言
在印度，乳腺癌往往在晚期才被诊断出来，这导致很大比例的患者接受改良根治性乳房切除术（MRM）作为主要手术治疗方式。虽然MRM有效，但它会带来显著的长期身体和心理社会发病率。本研究旨在利用更新后的欧洲癌症研究与治疗组织（EORTC）QLQ-BR42问卷，评估在三级医疗中心接受MRM治疗的乳腺癌幸存者的生活质量（QoL）。
方法
2024年9月至2025年6月，在班加罗尔的员工国家保险集团医学院（ESIC MC）和医学科学与研究研究生学院（PGIMSR）进行了一项横断面观察性研究。连续招募了300名接受过MRM并完成辅助治疗的女性乳腺癌幸存者。通过使用EORTC QLQ-BR42模块进行面对面访谈收集数据。计算QoL得分并转换为0至100分制。使用独立t检验和方差分析进行组间比较，以评估接受单一模式（仅辅助化疗）和接受双重模式（辅助化疗和放疗）患者之间的QoL差异。
结果
共纳入300名参与者，平均年龄为52.4±10.6岁。所有人都接受了MRM，其中66%（n = 198）接受双重模式治疗，34%（n = 102）接受单一模式治疗。研究发现身体形象满意度（79.77±8.99）和乳房满意度（70.0±8.50）的平均线性化得分较高。然而，未来展望领域受到中度影响（62.00±15.00）。症状领域显示乳房症状（55.68±24.90）和手臂症状（24.77±10.20）的症状负担最高。性健康是受损最严重的方面，性功能平均得分为1.67，性快感平均得分为0.00。单一模式和双重模式治疗组在任何QoL领域均未观察到统计学上的显著差异。
结论
我们的研究表明，该队列中接受MRM治疗的乳腺癌幸存者对其身体形象高度满意，但存在明显的身体症状且性健康严重受损。放疗的加入似乎并未对长期QoL产生显著影响。该研究强调需要提供全面、具有文化敏感性且资源适当的支持性护理，特别是关注性健康和症状管理，以改善这些幸存者的整体福祉。
