Patient-Reported Outcomes and Quality of Life Assessment in Breast Surgery Using BREAST-Q: A Multi-Center Prospective Study.

Abstract

Breast cancer remains the most frequently diagnosed cancer among women globally, including Malaysia. Patient reported outcomes (PROs) such as satisfaction and quality of life (QOL) have become crucial in evaluating the effectiveness of breast surgery, especially as survival rates improve. The BREAST-Q, a validated PRO measure, was developed to assess these factors from the patient perspective. This study aims to evaluate and compare the QOL and satisfaction outcomes between mastectomy and breast-conserving surgery (BCS) among Malaysian breast cancer patients. This multi-center, prospective cohort study included 230 women with stage 0 to III breast cancer undergoing mastectomy or BCS from January 2022 to April 2023. This study was conducted at Universiti Malaya Medical Center, Hospital Putrajaya, and Hospital Sultan Ismail Johor Bahru. The BREAST-Q questionnaire was administered preoperatively, and at 6 and 12 months postoperatively. Data were analyzed using descriptive statistics, independent t-tests, and ANOVA for multivariate analysis. Out of 230 patients, 49.6% had mastectomies, and 50.4% had BCS. BCS patients reported significantly higher satisfaction and QOL across domains, particularly in psychosocial and sexual well-being at all postoperative time points. Physical well-being favored the BCS group only at the 12-month mark. Satisfaction with the surgeon and medical team was notably higher in the mastectomy group. BCS was associated with higher patient satisfaction and QOL than mastectomy, suggesting it as a beneficial surgical option. The BREAST-Q tool provides a valuable framework to aid patient-surgeon discussions, improve patient preparedness, and inform surgical decision-making.