Differences in Preoperative Health-Related Quality of Life between Women Receiving Mastectomy or Breast Conserving Surgery in a Prospectively Recruited Cohort of Breast Cancer Patients
Abstract
:1. Introduction
2. Materials and Methods
2.1. Design
2.2. Patient-Reported Outcomes
2.2.1. Patient-Health Questionnaire-9 (PHQ-9)
2.2.2. Generalized Anxiety Disorder (GAD-7)
2.2.3. Pain Intensity (P), Interference with Enjoyment of Life (E), and Interference with General Activity (G), PEG
2.2.4. EuroQoL EQ-5D-5L
2.2.5. Socioeconomic Status Variables
2.2.6. Breast-QTM
2.3. Analysis
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Appendix A
Regression Effect | PEG (Pain) | EQ-5D VAS (Health Status) | ||||
---|---|---|---|---|---|---|
Estimate | Standard Error | p-Value | Estimate | Standard Error | p-Value | |
Intercept | 2.57 | 0.49 | <0.01 | 67.3 | 3.97 | <0.01 |
Age (Years) | −0.01 | 0.01 | 0.68 | 0.05 | 0.05 | 0.32 |
Charlson Index | ||||||
0 | −0.21 | 0.39 | 0.58 | 6.65 | 2.87 | 0.02 |
1–2 | −0.18 | 0.27 | 0.51 | 4.33 | 2.25 | 0.05 |
3+ | Reference | Reference | ||||
Surgery type | ||||||
Breast Conserving Surgery | −0.12 | 0.19 | 0.52 | 1.38 | 1.59 | 0.38 |
Total mastectomy | Reference | Reference | ||||
SES 5—Situational vulnerability | ||||||
Q1 Least Vulnerable | −0.97 | 0.35 | <0.01 | 0.88 | 2.88 | 0.75 |
Q2 | −0.5 | 0.34 | 0.14 | −0.43 | 2.83 | 0.87 |
Q3 | −0.71 | 0.33 | 0.03 | −1.36 | 2.77 | 0.62 |
Q4 | −0.94 | 0.33 | <0.01 | −1.08 | 2.72 | 0.69 |
Q5 Most Vulnerable | Reference | Reference | ||||
SES—Ethno-cultural composition | ||||||
Q1 Least Diverse | −0.04 | 0.5 | 0.92 | 0.01 | 4.11 | 0.99 |
Q2 | 0.56 | 0.4 | 0.16 | −4.52 | 3.3 | 0.17 |
Q3 | 0.12 | 0.3 | 0.67 | −2.2 | 2.46 | 0.37 |
Q4 | 0.32 | 0.22 | 0.15 | −0.69 | 1.86 | 0.7 |
Q5 Most Diverse | Reference | Reference |
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Patient Characteristic | Overall Sample (N = 671) | Breast-Conserving Surgery (N = 443) | Total Mastectomy (N = 228) | p-Value |
---|---|---|---|---|
Age | ||||
<49 | 27.57% | 20.54% | 41.34% | <0.01 |
50–59 | 23.25% | 20.99% | 27.63% | |
60–69 | 27.87% | 34.31% | 15.35% | |
>70 | 21.31% | 24.15% | 15.79% | |
Charlson Index | ||||
0 | 16.55% | 18.57% | 12.21% | <0.01 |
1–2 | 57.66% | 62.14% | 48.09% | |
3+ | 25.79% | 19.29% | 39.69% | |
SES 1—Situational vulnerability | ||||
Q1 Least Vulnerable | 27.75% | 28.54% | 26.22% | 0.86 |
Q2 | 21.57% | 22.15% | 20.44% | |
Q3 | 19.61% | 19.41% | 20.00% | |
Q4 | 20.51% | 20.09% | 21.33% | |
Q5 Most Vulnerable | 10.56% | 9.82% | 12.00% | |
SES—Ethno-cultural composition | ||||
Q1 Least Diverse | 3.32% | 2.97% | 4.00% | <0.01 |
Q2 | 5.73% | 5.94% | 5.33% | |
Q3 | 15.84% | 19.41% | 8.89% | |
Q4 | 38.76% | 38.36% | 39.56% | |
Q5 Most Diverse | 36.35% | 33.33% | 42.22% |
Patient-Reported Outcome | Overall | Breast-Conserving Surgery | Total Mastectomy | F-Stat | |||
---|---|---|---|---|---|---|---|
Mean | SD | Mean | SD | Mean | SD | p-Value | |
PHQ-9 2 | 4.64 | 4.7 | 4.36 | 4.48 | 5.18 | 5.06 | 0.03 |
GAD-7 | 4.66 | 4.96 | 4.17 | 4.5 | 5.73 | 5.72 | <0.01 |
PEG | 1.64 | 2.25 | 1.58 | 2.21 | 1.77 | 2.31 | 0.31 |
EQ-5D VAS | 73.96 | 18.29 | 74.82 | 17.96 | 72.26 | 18.84 | 0.08 |
Patient-Reported Outcome | Overall | Breast-Conserving Surgery | Total Mastectomy | Chi-Sq | |||
---|---|---|---|---|---|---|---|
N | % | N | % | N | % | p-Value | |
PHQ-9 3 (depression) | |||||||
≥10, Moderate | 89 | 13.26% | 55 | 12.42% | 34 | 14.91% | 0.36 |
≥15, Severe | 36 | 5.37% | 18 | 4.06% | 18 | 7.89% | 0.03 |
GAD-7 (anxiety) | |||||||
≥10, Moderate | 56 | 8.35% | 33 | 7.45% | 23 | 10.09% | 0.24 |
≥15, Severe | 19 | 2.83% | 8 | 1.81% | 11 | 4.82% | 0.02 |
Regression Effect | PHQ-9 (Depression) | GAD-7 (Anxiety) | ||||
---|---|---|---|---|---|---|
Estimate | Standard Error | p-Value | Estimate | Standard Error | p-Value | |
Intercept | 9.87 | 1.00 | <0.01 | 9.48 | 1.25 | <0.01 |
Age (Years) | −0.08 | 0.01 | <0.01 | −0.09 | 0.01 | <0.01 |
Charlson Index | ||||||
0 | −0.32 | 0.84 | 0.69 | −0.35 | 1.06 | 0.73 |
1–2 | −0.62 | 0.64 | 0.33 | −0.32 | 0.74 | 0.66 |
3+ | Reference | |||||
Surgery type | ||||||
Breast-conserving surgery | −0.17 | 0.40 | 0.67 | −0.74 | 0.50 | 0.14 |
Total mastectomy | Reference | Reference | ||||
SES 4—Situational vulnerability | ||||||
Q1 Least Vulnerable | −0.33 | 0.71 | 0.63 | 0.64 | 0.93 | 0.49 |
Q2 | 0.26 | 0.69 | 0.70 | 0.77 | 0.89 | 0.38 |
Q3 | 0.80 | 0.68 | 0.23 | 1.15 | 0.86 | 0.18 |
Q4 | 0.02 | 0.67 | 0.96 | 0.80 | 0.85 | 0.34 |
Q5 Most Vulnerable | Reference | Reference | ||||
SES—Ethno-cultural composition | ||||||
Q1 Least Diverse | −0.02 | 1.02 | 0.98 | 0.42 | 1.32 | 0.74 |
Q2 | 0.57 | 0.82 | 0.48 | 1.38 | 1.02 | 0.17 |
Q3 | 0.30 | 0.61 | 0.61 | −0.43 | 0.78 | 0.58 |
Q4 | 0.44 | 0.46 | 0.32 | 0.91 | 0.58 | 0.11 |
Q5 Most Diverse | Reference | Reference |
Breast-QTM Scale: | Breast-Conserving Surgery | Total Mastectomy | |||
---|---|---|---|---|---|
Mean | SD | Mean | SD | p-Value | |
Satisfaction with breasts | 67 | 21.9 | 62.5 | 22.2 | 0.014 |
Psychosocial well-being | 72.8 | 19.9 | 68.4 | 21.9 | 0.011 |
Physical well-being | 79.2 | 15.8 | 74.2 | 15.9 | <0.001 |
Sexual well-being | 57.1 | 24.1 | 54.2 | 25.9 | 0.21 |
Patient-Reported Outcome | Total Mastectomy with Immediate Breast Reconstruction | Total Mastectomy Alone | |||
---|---|---|---|---|---|
Mean | SD | Mean | SD | p-Value | |
PHQ-9 2 | 6.03 | 5.55 | 3.84 | 3.85 | <0.01 |
GAD-7 | 6.45 | 6.02 | 4.42 | 4.94 | 0.07 |
PEG | 1.63 | 2.22 | 1.98 | 2.45 | 0.25 |
EQ-5D VAS | 74.44 | 17.61 | 68.92 | 20.24 | 0.03 |
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McKevitt, E.; Saleeb, M.; Liu, G.; Warburton, R.; Pao, J.-S.; Dingee, C.; Bazzarelli, A.; Tang, K.; Crump, T.; Sutherland, J.M. Differences in Preoperative Health-Related Quality of Life between Women Receiving Mastectomy or Breast Conserving Surgery in a Prospectively Recruited Cohort of Breast Cancer Patients. Curr. Oncol. 2023, 30, 118-129. https://doi.org/10.3390/curroncol30010010
McKevitt E, Saleeb M, Liu G, Warburton R, Pao J-S, Dingee C, Bazzarelli A, Tang K, Crump T, Sutherland JM. Differences in Preoperative Health-Related Quality of Life between Women Receiving Mastectomy or Breast Conserving Surgery in a Prospectively Recruited Cohort of Breast Cancer Patients. Current Oncology. 2023; 30(1):118-129. https://doi.org/10.3390/curroncol30010010
Chicago/Turabian StyleMcKevitt, Elaine, Maria Saleeb, Guiping Liu, Rebecca Warburton, Jin-Si Pao, Carol Dingee, Amy Bazzarelli, Katelynn Tang, Trafford Crump, and Jason M. Sutherland. 2023. "Differences in Preoperative Health-Related Quality of Life between Women Receiving Mastectomy or Breast Conserving Surgery in a Prospectively Recruited Cohort of Breast Cancer Patients" Current Oncology 30, no. 1: 118-129. https://doi.org/10.3390/curroncol30010010