Author/Authors :
Hazawa, Yuri Department of Nursing and Surgical Science - Sapporo Medical University Postgraduate School of Health Science, Sapporo, Japan , Kutomib, Goro epartment of Surgery - Surgical Science and Oncology - Sapporo Medical University Postgraduate School of Medicine, Sapporo, Japan , Shimab, Hiroaki epartment of Surgery - Surgical Science and Oncology - Sapporo Medical University Postgraduate School of Medicine, Sapporo, Japan , Honmac,Toshio Department of Breast Surgery - Sapporo Breast Surgical Clinic, Sapporo, Japan , Ohmura,Tosei Department of Surgery - Higashi-Sapporo Hospital, Sapporo, Japan , Wada, Asaka epartment of Surgery - Surgical Science and Oncology - Sapporo Medical University Postgraduate School of Medicine, Sapporo, Japan , Mikami,Toshihiko Department of Breast Surgery - Sapporo Kotoni Breast Clinic, Sapporo, Japan , Hottae, Miki Department of Breast Surgery - Sapporo Kotoni Breast Clinic, Sapporo, Japan , Narumia, Momoka Department of Nursing and Surgical Science - Sapporo Medical University Postgraduate School of Health Science, Sapporo, Japan , Kunoa,Yoshika Department of Nursing and Surgical Science - Sapporo Medical University Postgraduate School of Health Science, Sapporo, Japan , Ishinukia,Tomohiro Department of Nursing and Surgical Science - Sapporo Medical University Postgraduate School of Health Science, Sapporo, Japan , Megurod, Makoto epartment of Surgery - Surgical Science and Oncology - Sapporo Medical University Postgraduate School of Medicine, Sapporo, Japan , Takemasa, Ichiro Department of Nursing and Surgical Science - Sapporo Medical University Postgraduate School of Health Science, Sapporo, Japan , Okazaki, Minoru Department of Breast Surgery - Sapporo Breast Surgical Clinic, Sapporo, Japan , Masuoka, Hideji Department of Breast Surgery - Sapporo Breast Surgical Clinic, Sapporo, Japan , Asaishi, Kazuaki Department of Breast Surgery - Sapporo Breast Surgical Clinic, Sapporo, Japan , Ohyanagi,Toshio Department of Liberal Arts and Sciences - Center for Medical Education - Sapporo Medical University , Huig,Thomas T. Department of Surgery - Division of Pediatric Surgery - Stanford University School of Medicine, Stanford, CA, USA , Mizuguchi, Toru Department of Nursing and Surgical Science - Sapporo Medical University Postgraduate School of Health Science, Sapporo, Japan
Abstract :
Background: Improving health-related quality of life (HRQOL) has become a fundamental goal of breast cancer management. This study aimed to examine the differences between the QOL outcomes of breast-conserving surgery (BCS) and mastectomy. We also established structural equation models for BCS and mastectomy to elucidate their unique effects on QOL.
Methods: Between July 2019 and November 2019, 254 patients, who were scheduled to visit one of four clinics, were recruited for this study. We evaluated HRQOL using various questionnaires, such as the BREAST-Q, EQ-5D-5L, and Hospital Anxiety and Depression Scale (HADS). The relationships among the examined clinical indicators were evaluated using structural equation modeling (SEM).
Results: The QOL scores of the BCS group were better than those of the mastectomy group (0.85±0.129 vs. 0.81±0.12, P=0.020). Also, anxiety (2.94±2.95 vs. 3.81±3.08, P=0.025) and depression (2.55±2.77 vs. 3.74±3.19, P=0.002) were less severe in the BCS group than in the mastectomy group. Furthermore, the relationships among QOL status and mental health status were more complex in the BCS group than in the mastectomy group (Chi-square minimization p-value: 0.231 vs. 0.469, respectively). Also, depression directly affected QOL in the mastectomy group (R=-0.47), but not in the BCS group.
Conclusions: There were differences in QOL and mental health between the BCS and mastectomy groups. SEM is useful for identifying such differences, which can be used to develop strategies for improving QOL.
