Skip to main content Skip to main navigation menu Skip to site footer

Breast-conserving surgery and mastectomy towards quality of life: a systematic review and meta-analysis

Abstract

Background: Breast cancer (BC) is still the most frequent cancer among women. Surgery for BC frequently starts with either a mastectomy or a breast-conserving surgery (BCS). There is still controversy regarding better QoL between them. This study purposed to evaluate the BCS and mastectomy towards QoL in systematic review and meta-analysis.

Methods: This review was conducted following the 2020 PRISMA guidelines. A systematic search was conducted on electronic databases (PubMed, ScienceDirect, Springer Link, and Google Scholar). Data extraction and study quality assessment were done using the PICOS strategy and NOS checklist. The mean difference parameter was used to determine differences in group quality scores. The accepted significant p-value is <0.05.

Results: 12 studies involving 5311 BC patients undergoing either BCS (n=3254) or mastectomy (n=2057) were obtained. Most of the study designs used a prospective cohort design. There was no significant difference of QoL between BCS and mastectomy group in the breast satisfaction domain (MD 5.96; 95%CI -1.70 – 13.62; p=0.13; heterogeneity, I2=99%; p<0.001), psychosocial well-being domain (MD -0.45; 95%CI -10.27 – 9.37; p=0.93; heterogeneity, I2=94%; p<0.001), and physical well-being domain (MD 3.07; 95%CI -2.05 – 0.20; p=0.24; heterogeneity, I2=98%; p<0.001). However, there was a significant difference in the sexual well-being domain (MD 5.06; 95%CI 0.89 – 9.24; p=0.02; heterogeneity, I2=100%; p<0.001).

Conclusion: Patients who had BCS have similar QoL but higher sexual well-being compared to patients who had mastectomy.

References

  1. Mokhatri-Hesari P, Montazeri A. Health-related quality of life in breast cancer patients: Review of reviews from 2008 to 2018. Health Qual Life Outcomes. 2020;18(1):1–25.
  2. Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin. 2021;71(3):209–49.
  3. Cardoso F, Kyriakides S, Ohno S, Penault-Llorca F, Poortmans P, Rubio IT, et al. Early breast cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol [Internet]. 2019;30(8):1194–220. Available from: https://doi.org/10.1093/annonc/mdz173
  4. Bottomley A, Reijneveld JC, Koller M, Flechtner H, Tomaszewski KA, Greimel E, et al. The current state of quality of life and patient-reported outcomes research. Eur J Cancer. 2019;121:55–63.
  5. Fortin J, Leblanc M, Elgbeili G, Cordova MJ, Marin M-F, Brunet A. The mental health impacts of receiving a breast cancer diagnosis: A meta-analysis. Br J Cancer [Internet]. 2021;125(11):1582–92. Available from: https://doi.org/10.1038/s41416-021-01542-3
  6. Gu J, Delisle M, Engler-Stringer R, Groot G. Mastectomy versus breast-conservation therapy: Examining how individual, clinicopathologic, and physician factors influence decision-making. Curr Oncol. 2019;26(4):e522–34.
  7. Christiansen P, Mele M, Bodilsen A, Rocco N, Zachariae R. Breast-Conserving Surgery or Mastectomy? Ann Surg Open. 2022;4:e205.
  8. American Cancer Society. Mastectomy [Internet]. 2021 [cited 2023 Nov 12]. Available from: https://www.cancer.org/cancer/types/breast-cancer/treatment/surgery-for-breast-cancer/mastectomy.html#:~:text=Mastectomy is breast cancer surgery,saves most of the breast.
  9. Alvarez-Pardo S, Romero-Pérez EM, Camberos-Castañeda N, de Paz JA, Horta-Gim MA, González-Bernal JJ, et al. Quality of Life in Breast Cancer Survivors in Relation to Age, Type of Surgery and Length of Time since First Treatment. Int J Environ Res Public Health. 2022;19:16229.
  10. Miranda I, Lichtenfels M, Vollbrecht B, Barbosa F. Quality of life and patient satisfaction after breast reconstruction. Chirurg. 2022;77(7):610–5.
  11. Elmas Ö, Karadeniz Cakmak G, Bakkal BH. A Comparison Between Modified Radical Mastectomy and Breast-Conserving Surgery Concerning the Quality of Life in Patients with Breast Cancer Under 50 Years of Age. Batı Karadeniz Tıp Derg. 2021;5(1):63–7.
  12. McKevitt E, Saleeb M, Liu G, Warburton R, Pao JS, Dingee C, et al. 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(1):118–29.
  13. Srimontayamas S, Sa-Nguanraksa D, Lohsiriwat V, Rushatamukayanunt P, Imruetaicharoenchoke W, Prasartong-Osoth P, et al. Quality of life in breast cancer survivors: Comparative study of mastectomy, mastectomy with immediate transverse rectus abdominis musculocutaneous flap reconstruction and breast conserving surgery. J Med Assoc Thail. 2017;100(4):S38–45.
  14. Elfgen C, Güth U, Gruber G, Birrer S, Bjelic-Radisic V, Fleisch M, et al. Breast-conserving surgery with intraoperative radiotherapy in recurrent breast cancer: the patient’s perspective. Breast Cancer [Internet]. 2020;27(6):1107–13. Available from: https://doi.org/10.1007/s12282-020-01114-y
  15. Deepa K V., Gadgil A, Löfgren J, Mehare S, Bhandarkar P, Roy N. Is quality of life after mastectomy comparable to that after breast conservation surgery? A 5-year follow up study from Mumbai, India. Qual Life Res [Internet]. 2020;29(3):683–92. Available from: https://doi.org/10.1007/s11136-019-02351-1
  16. Flanagan MR, Zabor EC, Romanoff A, Fuzesi S, Stempel M, Mehrara BJ, et al. A Comparison of Patient-Reported Outcomes After Breast-Conserving Surgery and Mastectomy with Implant Breast Reconstruction. Ann Surg Oncol. 2019;26(10):3133–40.
  17. Builes Ramírez S, Acea Nebril B, García Novoa A, Cereijo C, Bouzón A, Mosquera Oses J. Evaluation of the Preoperative Perception of Quality of Life and Satisfaction of Women With Breast Cancer Using the BREAST-QTM Questionnaire. Cirugía Española (English Ed. 2020;98(4):212–8.
  18. Tarkowska M. Assessment of quality of life and selected aspects of physical, psychological, social, and environmental functioning in patients treated for breast cancer 5 years after breast-conserving surgery or mastectomy. 2019;9(4):1–23.
  19. Deniz A. The Comparison Of Breast Conserving Surgery And Subcutaneous Mastectomy With Implant Reconstruction Regarding Postoperative Quality Of Life In Patients With Breast Cancer. South Clin Istanbul Eurasia. 2019;30(3):272–6.
  20. Howes BHL, Watson DI, Xu C, Fosh B, Canepa M, Dean NR. Quality of life following total mastectomy with and without reconstruction versus breast-conserving surgery for breast cancer: A case-controlled cohort study. J Plast Reconstr Aesthetic Surg. 2016;69(9):1184–91.
  21. Acea-Nebril B, García-Novoa A, Cereijo-Garea C, Builes-Ramirez S, Bouzon-Alejandro A, Mosquera-Oses J. Single-Incision Approach for Breast-Conserving Surgery: Effectiveness, Complications and Quality of Life. Ann Surg Oncol. 2019;26(8):2466–74.
  22. Ng ET, Ang RZ, Tran BX, Ho CS, Zhang Z, Tan W, et al. Comparing quality of life in breast cancer patients who underwent mastectomy versus breast-conserving surgery: A meta-analysis. Int J Environ Res Public Health. 2019;16(24):1–10.
  23. Zehra S, Doyle F, Barry M, Walsh S, Kell MR. Health-related quality of life following breast reconstruction compared to total mastectomy and breast-conserving surgery among breast cancer survivors: a systematic review and meta-analysis [Internet]. Vol. 27, Breast Cancer. Springer Japan; 2020. 534–566 p. Available from: https://doi.org/10.1007/s12282-020-01076-1
  24. Salafuddin MF, Yarso KY, Nugroho HA, Renardi AS. Breast Conserving Surgery is Better for Sexual Satisfaction Compared to a Modified Radical Mastectomy for Breast Cancer. Asian Pacific J Cancer Prev. 2023;24(6):2083–8.
  25. Elmas Ö, Karadeniz Çakmak G, Bakkal BH. A comparison between breast-conserving surgery and modified radical mastectomy concerning the female sexual function in breast cancer patients under 50 years of age. Turk Onkol Derg. 2020;35(1):26–30.
  26. Bond CB, Jensen PT, Groenvold M, Johnsen AT. Prevalence and possible predictors of sexual dysfunction and self-reported needs related to the sexual life of advanced cancer patients. Acta Oncol (Madr) [Internet]. 2019;58(5):769–75. Available from: https://doi.org/10.1080/0284186X.2019.1566774
  27. Scavello I, Maseroli E, Di Stasi V, Vignozzi L. Sexual health in menopause. Med. 2019;55:559.
  28. Dahlui M, Azzani M, Taib NA, Hoong SM, Jamaris S, Islam T. Breast conserving surgery versus mastectomy : the effect of surgery on quality of life in breast cancer survivors in Malaysia. BMC Womens Health [Internet]. 2023;23:607. Available from: https://doi.org/10.1186/s12905-023-02738-w
  29. Christiansen P, Carstensen SL, Ejlertsen B, Kroman N, Offersen B, Bodilsen A, et al. Breast conserving surgery versus mastectomy: overall and relative survival—a population based study by the Danish Breast Cancer Cooperative Group (DBCG). Acta Oncol (Madr) [Internet]. 2018;57(1):19–25. Available from: https://doi.org/10.1080/0284186X.2017.1403042

How to Cite

Githa, I. P. A. R., & Bandem, I. N. G. S. . (2023). Breast-conserving surgery and mastectomy towards quality of life: a systematic review and meta-analysis. Intisari Sains Medis, 14(3), 1140–1145. https://doi.org/10.15562/ism.v14i3.1893

HTML
0

Total
0

Share

Search Panel

I Putu Agni Rangga Githa
Google Scholar
Pubmed
ISM Journal


I Nyoman Gede Susila Bandem
Google Scholar
Pubmed
ISM Journal