Impact of breast cancer surgical procedures on postoperative daily life: a multicenter patient-reported outcomes study.

BACKGROUND

Contemporary breast cancer treatment emphasizes both oncological outcomes and preservation of health-related quality of life. However, few studies have examined how different surgical procedures affect patients' postoperative daily life. This study aimed to clarify the impact of various surgical approaches on the postoperative daily lives of Japanese patients with breast cancer.

METHODS

This multicenter cross-sectional survey (administered once between 2022 and 2024) was conducted among 561 Japanese women who had undergone mastectomy (MT), breast-conserving surgery (BCS), or immediate breast reconstruction (IBR) for breast cancer between August 2013 and July 2021. Participants completed a study-specific questionnaire assessing the perceived impact of surgery on daily-life domains, including clothing selection, employment, housework, hobbies, partner relationships, and sexual activity. We also performed an exploratory analysis of write-in responses provided by participants who selected 'Other' to identify additional factors. Clinical and treatment variables were retrospectively abstracted from medical records. Multivariable analyses were conducted to identify factors associated with postoperative impact on daily life.

RESULTS

The MT group reported more impairment in clothing selection (45.5%) and a significantly higher proportion reporting onsen-use difficulty in the 'Other' write-in field (7.9%; exploratory endpoint) than BCS (13.1% and 0.6%, respectively) and IBR (16.0% and 2.1%, respectively) groups. Other domains showed no significant differences. MT remained a significant independent predictor in multivariable analyses.

CONCLUSIONS

The impact of breast cancer surgery on postoperative daily life varied by procedure type. MT most affected clothing selection and onsen use. Providing information on procedural differences in potential impacts may support shared decision-making.