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The impact of breast cosmetic and functional outcomes on quality of life: long-term results from the St. George and Wollongong randomized breast boost trial

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Abstract

The aims of this study were to evaluate the impact of cosmetic and functional outcomes after breast-conserving surgery (BCS) and radiation on quality of life (QOL). In this exploratory analysis; baseline, 5 and 10 years data of patient’s assessment of breast cosmesis, arm swelling/pain, limitation of movement, loss of feeling in fingers and breast sensitivity/tenderness were dichotomized and their impact on QOL (QLQ-C30) were assessed. Multivariable modelling was also performed to assess associations with QOL. The St. George and Wollongong randomized trial randomized 688 patients into the boost and no boost arms. 609, 580, and 428 patients had baseline, 5 and 10 years cosmetic data available, respectively. Similar numbers had the various functional assessments in the corresponding period. By univariate analysis, cosmesis and a number of functional outcomes were highly associated with QOL. Adjusted multivariate modelling showed that cosmesis remained associated with QOL at 5 and 10 years. Breast sensitivity, arm pain, breast separation, age and any distant cancer event were also associated with QOL on multivariate modelling at 10 years. This study highlights the importance of maintaining favorable cosmetic and functional outcomes following BCS. In addition, the clinically and statistically significant relationship between functional outcomes and QOL shows the importance for clinicians and allied health professionals in identifying, discussing, managing, and limiting these effects in women with breast cancer in order to maintain QOL.

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Conflict of interest

None.

Ethical standard

Ethics approval was obtained for the St George and Wollongong Randomized Trial. The trial is registered with www.clinicaltrials.gov (NCT00138814).

Author information

Authors and Affiliations

  1. Department of Radiation Oncology, Cancer Care Centre, St. George Hospital, Gray Street, Kogarah, Sydney, NSW, 2217, Australia

    Eric Hau, Lois Browne, John H. Kearsley & Peter H. Graham

  2. Faculty of Medicine, University of NSW, Kensington, NSW, Australia

    Eric Hau, John H. Kearsley, Ewan Millar, George Papadatos & Peter H. Graham

  3. Department of Radiation Oncology, Calvary Mater Newcastle, Waratah, NSW, Australia

    Anne Capp

  4. University of Newcastle, Newcastle, NSW, Australia

    Anne Capp

  5. School of Medicine and Health Sciences, University of Western Sydney, Campbelltown, NSW, Australia

    Geoff P. Delaney & Ewan Millar

  6. Collaboration for Cancer Outcomes Research and Evaluation, University of NSW, Liverpool Hospital Campus, Liverpool, NSW, Australia

    Geoff P. Delaney

  7. Department of Radiation Oncology, Liverpool Hospital, Liverpool, NSW, Australia

    Geoff P. Delaney

  8. Department of Radiation Oncology, Wollongong Hospital, Wollongong, NSW, Australia

    Christopher Fox & Elias H. Nasser

  9. Department of Anatomical Pathology, South Eastern Area Laboratory Service, St. George Hospital, Kogarah, Sydney, NSW, 2217, Australia

    Ewan Millar

  10. Cancer Research Program, The Kinghorn Cancer Centre & Garvan Institute of Medical Research, Darlinghurst, NSW, 2010, Australia

    Ewan Millar

  11. Macarthur Cancer Therapy Centre, Campbelltown, NSW, Australia

    George Papadatos

Authors
  1. Eric Hau
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  2. Lois Browne
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  3. Anne Capp
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  4. Geoff P. Delaney
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  5. Christopher Fox
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  6. John H. Kearsley
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  7. Ewan Millar
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  8. Elias H. Nasser
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  9. George Papadatos
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  10. Peter H. Graham
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Corresponding author

Correspondence to Eric Hau.

Additional information

Annual scientific meeting in Cairns, Australia as poster presentation in July 2012.

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Hau, E., Browne, L., Capp, A. et al. The impact of breast cosmetic and functional outcomes on quality of life: long-term results from the St. George and Wollongong randomized breast boost trial. Breast Cancer Res Treat 139, 115–123 (2013). https://doi.org/10.1007/s10549-013-2508-z

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  • DOI: https://doi.org/10.1007/s10549-013-2508-z

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