The Effect Of Type Of Surgery On Quality Of Life In Patients With Early Stage Breast Cancer

Objective To measure the reliability and validity of the QLQ-BR23used among Chinese patients with breast cancer, evaluate quality of life in patients with early stage breast cancer, analyse the effect of the type of surgery on quality of life, report the process of surgical treatment decision-making in Chinese breast cancer women. This study will benefit the preoperative health education and provide the theoretical support and the practical guidance for the postoperative intervention of rehabilitative care .Methods Subjects were 190 early-stage breast cancer patients in the Breast Department at Beijing Oncology Hospital and the First Clinical Hospital of Peking University , 50 breast-conserving surgery (BCS)and 140 modified radical mastectomy(MRM) were received. Inclusion criteria include: ①between six months and five years after surgery, ②below 70 years old, ③ no other disease and metastasis now, ④ finished chemotherapy and radiotherapy, ⑤no mental disease and disturbance of consciousness, ⑥willing to participate the study. The investigation method (including descriptive research and analysis research)was used. Four questionnaires were used to collect data in this study. The demographic and medical data of subjects were received by the generalinformation form, and Quality of Life Questionnaire-Core 30 (:!.,? and the Breast cancer module-23 developed by European Organization for Research and Treatment of Cancer were used to evaluate the level of quality of life of breast cancer patients, and the state of treatment decision-making was reported by the interview questions designed by the researcher. The data were calculated by SPSS10. 0. The rate of treatment decision-making was compared by a-'-test, the quality of life between two groups and the interaction between the type of surgery and age or the different stage after surgery by multivariate ANOVA.Results1. The Cronbach' s alpha coefficient of Q0L-BR23 is 0.85, and the BRST(0. 70), BRBI(0. 89), BRSEF(0. 89), BRAS(0. 69), BRBS(0. 70). The principal components analysis with varimax rotated solution was used to measure the construct validity, there are six factors extracted which can explain 64.80% variance totally, among them, four factors represent BRBI, BRSEF and BRSEE, BRAS, BRBS respectively, and the rest two factors represent the BRST, BRHL and BRFU together.2. The scores of PF2, RF2, EF2 in the QLQ-C30 were higher than the mean w; th statistical di fference, but the scores of FA, NV, PA, SL, FI were lower than the mean, the scores of QL2, CF, SF,DY,DI had no statistical difference.?■. There was the significant difference between BCS and MRM group about quality of life, mostly in the body image( F =13.29, P(0. 05), the rest scores of the other sub-scale were no statistical difference. But the effect of type of surgery on quality of life of breast cancer patients was different in the different stage after surgery, and the same effect on that of the younger group and the older group.4. When comes to the treatment decision-making, 66. 1% among 190 patients said that their type of surgery were made by the surgeon, 24% bythemselves , and 40. 8% of BCS made by themselves , while 17. 9% of MRM. And thev considered the curative effect was most important and the appearance next when they made the deci sion. There was statistical difference between the two groups in the effect of breast cancer on body image and the BCS group had better one ( x'—34. 1, P <0. 05). On the other hand, the effect of breast cancer on the sexual function was no statistical difference between the two groups ( x2—3. 44, P >0. 05) ?Conclusion1. The QLQ-BR23 scale has good reliability and validity used in the breast cancer patients in China .2. The patients with BCS had better quality of life than those with MRM , mostly in body image. But the effect of type of surgery on quality of I l fe in the breast cancer patient was different in the different stage after surgery, while there was the same effect on the younger group and older group.3. The surgeon in China made more treatment decisions for their breast cancer patients. Meanwhile, patients with BCS had gotten more information support and made treatment decisions more by themselves than those of MRM. Those who had the chance to take part in the treatment decisions had belter psychological adaptation.