Long-term quality of life, body image and anxiety in women after breast cancer

Purpose: Research on long-term quality of life after breast cancer has produced conflicting results. We investigated the impact of age, recurrence, and type of primary surgery on different aspects of long-term quality of life in women treated for breast cancer. Methods: A total of 306 women completed the QLQ-C30 (Version 2.0) questionnaire an average of 4.2 years after primary treatment for stage I-Ill breast cancer. Supplementary scales included body image, satisfaction with surgical treatment, and fear of recurrence. Results: The women had minor impairment of quality of life (67.0) and body image (25.9), a high degree of satisfaction with surgical treatment (6.8), and considerable fear of recurrence (61.4). There was no correlation between age and quality of life. Women with recurrence did not differ from those without recurrence in the symptom scales of the questionnaire. Women with recurrence reported lower quality of life (P < 0.01), less satisfaction with surgical treatment (P < 0.04), and more anxiety (P = 0.02). The QLQ-C30 questionnaire failed to demonstrate a difference in overall long-term quality of life between women who had undergone breast-conserving therapy and those who underwent mastectomy. In contrast, primary surgical treatment did have an impact on the additional psychological scales: women after mastectomy had a less favorable body image (P < 0.01), less satisfaction with surgical treatment (P < 0.01) but also less fear of recurrence (P < 0.01) than women after conservative surgery. Conclusion: These data support the hypothesis that the standardized QLQ-C30 questionnaire does not sufficiently cover all relevant aspects of quality of life and that it might be complemented with aspects specific for breast cancer, such as body image, satisfaction with surgical treatment, and anxiety.