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      The quality of life of Croatian women after mastectomy: a cross-sectional single-center study

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          Abstract

          Background

          Measuring the quality of life (QoL) of women with breast cancer is an important aspect of measuring treatment success. In Croatia, no QoL studies have been carried out with a focus on patients after mastectomy. The aim of this study was to examine QoL 1 month and 1 year after mastectomy.

          Methods

          This cross-sectional single-center study of quality of life was conducted in 101 patients, 50 of whom had undergone a mastectomy 1 month prior, and 51 of whom had undergone a mastectomy 1 year prior. The study was conducted from July 2015 to June 2016. The questionnaires used in the study were developed by the European Organisation for Research and Treatment of Cancer (EORTC). The questionnaire EORTC QLQ-C30 assesses the QoL of cancer patients, and the questionnaire EORTC QLQ-BR23 is a disease-specific breast cancer module. A chi square test, Fisher’s exact test, Kolmogorov-Smirnov test, Student’s t-test and Mann-Whitney U test were performed in the statistical analysis using the statistical program SPSS (Inc. Released 2008. SPSS Statistics for Windows, Version 17.0. Chicago: SPSS Inc.).

          Results

          Patients who had undergone a mastectomy a year earlier placed a higher value on their health state than did those who had undergone a mastectomy a month earlier. The most affected values of functional status on the EORTC QLQ-C30 scale were emotional functioning (37.5 [95% CI 33.3–61.6]) and sexual functioning (16.67 [95% CI 0–33.3]) 1 month and 1 year after mastectomy, respectively. The most affected symptoms on the EORTC QLQ-C30 scale were hair loss 66.67 [95% CI 33.3–100]) and fatigue 33.33 [95% CI 24–44]) 1 month and 1 year after mastectomy, respectively.

          Conclusion

          In our study, both functional and symptom scales were more affected in women 1 month after mastectomy. QoL was considerably improved in women 1 year after the surgery compared to 1 month after mastectomy. The results of this study could contribute to the public awareness of the QoL of breast cancer patients.

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          Most cited references28

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          Major depression after breast cancer: a review of epidemiology and treatment.

          While many breast cancer patients experience "normal" distress, there is a subset who experience clinically significant depression. We examined the current knowledge about the prevalence, impact and treatment of major depression in women with breast cancer. We reviewed the evidence for the prevalence of depression in women with breast cancer from the last 20 years and summarized the medical literature on the pharmacology and psychotherapy of depression in this population. Despite evidence that depression significantly impacts quality of life in breast cancer patients, few studies focus on the epidemiology and treatment of major depression. Treatment studies have focused on distress and mixed depressive states, with resulting lack of replicable studies showing treatment efficacy. Potential biological and psychosocial determinants of major depression following breast cancer are discussed in a proposed model. The need for further research on the epidemiology and treatment of major depression in this population is proposed. Major depression is a frequent but underrecognized and undertreated condition among breast cancer patients, which causes amplification of physical symptoms, increased functional impairment and poor treatment adherence. More research on the epidemiology and treatment of major depression in this population is needed.
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            Quality of life at the end of primary treatment of breast cancer: first results from the moving beyond cancer randomized trial.

            During the last decade, survival rates for breast cancer have increased as a result of earlier detection and increased use of adjuvant therapy. Limited data exist on the psychosocial aspects of the transitional period between the end of primary treatment and survivorship. We investigated the baseline psychosocial status of women enrolled in a randomized trial testing two psychosocial interventions for women at the end of primary treatment. Participants, identified within 1 month after surgery (registration), provided demographic information and limited measures of quality of life. They were followed until they finished primary treatment (enrollment), at which time they completed a mailed baseline survey that included standardized measures of quality of life (including standardized scales of physical and emotional functioning), mood, symptoms, and sexual functioning. A total of 558 patients (mean age = 56.9 years) were enrolled in the study between July 1, 1999, and June 30, 2002. Health outcomes were examined according to treatment received: mastectomy with and without chemotherapy, and lumpectomy with and without chemotherapy. All statistical tests were two-sided. Among all treatment groups, patients who had a mastectomy had the poorest physical functioning at registration (P<.001) and at enrollment (P=.05). At enrollment, mood and emotional functioning were similar among all patients, with no differences by type of treatment received. At enrollment, symptoms, including muscle stiffness, breast sensitivity, aches and pains, tendency to take naps, and difficulty concentrating, were common among patients in all groups and were statistically significantly associated with poor physical functioning and emotional well-being. Sexual functioning was worse for women who received chemotherapy than for those who did not, regardless of type of surgery (P<.001). At the end of primary treatment for breast cancer, women in all treatment groups report good emotional functioning but report decreased physical functioning, particularly among women who have a mastectomy or receive chemotherapy. Clinical interventions to address common symptoms associated with treatment should be considered to improve physical and emotional functioning at the end of primary treatment for breast cancer.
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              Quality of life following breast-conserving therapy or mastectomy: results of a 5-year prospective study.

              There are many conflicting results in the literature comparing quality of life following breast-conserving therapy (BCT) and mastectomy. This study compared long-term quality of life between breast cancer patients treated by BCT or mastectomy in three age groups. Patients (n = 990) completed a quality of life survey, including the European Organization for Research and Treatment of Cancer Quality of Life Core Questionnaire (EORTC QLQ-C30), at regular intervals over 5 years. In the cross-sectional data, mastectomy patients had significantly (p or =70 years of age reported higher body image and lifestyle scores when treated with BCT. The repeated measures analysis indicated that four functioning scores, half the symptom scores, future health, and global quality of life improved significantly (p < 0.01) over time. All these variables increased significantly for BCT patients and those 50 to 69 years of age. Body image, sexual functioning, and lifestyle disruption scores did not improve over time. BCT should be encouraged in all age groups. Coping with appearance change should be addressed in patient interventions.
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                Author and article information

                Contributors
                stana.pacaric@gmail.com
                kristek.jozo@kbo.hr
                medicina@mefos.hr
                gkondza@gmail.com
                turk.tajana@gmail.com
                nikfarcic@gmail.com
                zelimir.orkic@gmail.com
                ana.nemcic@gmail.com
                Journal
                BMC Public Health
                BMC Public Health
                BMC Public Health
                BioMed Central (London )
                1471-2458
                10 August 2018
                10 August 2018
                2018
                : 18
                : 999
                Affiliations
                [1 ]ISNI 0000 0001 1015 399X, GRID grid.412680.9, Department of Surgery, Faculty of Medicine, , University of Osijek, ; Osijek, Croatia
                [2 ]ISNI 0000 0004 0621 3082, GRID grid.412412.0, Department of Surgery, , University Hospital Osijek, ; Huttlerova 4, 31000 Osijek, Croatia
                [3 ]ISNI 0000 0001 1015 399X, GRID grid.412680.9, Faculty of Medicine, , University of Osijek, ; Cara Hadrijana 10/E, HR, 31000 Osijek, Croatia
                [4 ]ISNI 0000 0001 1015 399X, GRID grid.412680.9, Department of Biophysics and Radiology, Faculty of Medicine, , University of Osijek, ; Osijek, Croatia
                [5 ]ISNI 0000 0004 0621 3082, GRID grid.412412.0, Department of Diagnostic and Interventional Radiology, , University Hospital Osijek, ; Huttlerova 4, 31000 Osijek, Croatia
                [6 ]ISNI 0000 0001 1015 399X, GRID grid.412680.9, Department of Nursing, Medical Ethics and Palliative Medicine, Faculty of Medicine, , University of Osijek, ; Osijek, Croatia
                Author information
                http://orcid.org/0000-0003-3670-5910
                Article
                5929
                10.1186/s12889-018-5929-0
                6086072
                30097040
                f36552cc-ae9e-4c56-b643-211b2b10a3d8
                © The Author(s). 2018

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 27 January 2018
                : 2 August 2018
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2018

                Public health
                breast cancer,quality of life,mastectomy,satisfaction,woman
                Public health
                breast cancer, quality of life, mastectomy, satisfaction, woman

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