The quality of life of patients with early breast cancer and their partners one year after breast conserving surgery versus modified radical mastectomy: a single centre five year review

Background: Breast cancer accounts for the highest incidence rate (40.3/100000) and fourth highest mortality rate (17.8/100000) among cancers in Kenya. Forty percent of breast cancer cases in Kenya are early breast cancer and this is will increase with scaled up awareness campaigns and screening. Breast conserving surgery (BCS) followed by radiotherapy (BCT) and modified radical mastectomy (MRM) are the commonest forms of surgical techniques utilized in treatment of early breast cancer with similar overall survival and recurrence rates. These treatments impact variably on the quality of life of the patients and their spouses who are their immediate emotional and social support as per western studies. Our study aims to determine whether the type of surgical intervention affects quality of life of our patients and their spouses in our setting. Methods: Our study was a cross-sectional single center study conducted at Aga Khan University Hospital Nairobi. Eligible patients with early breast cancer and had undergone either BCT or MRM in the period between January 2013 and December 2018 voluntarily filled the validated generic cancer EORTC-QLQ-C30 questionnaire and a data collection sheet. Their willing spouses also filled in a 15D instrument questionnaire. Results: Eighty one patients and 11 spouses participated in the study. Forty patients had BCS/BCT and 39 had MRM. Patients who had undergone BCS/BCT had a better quality of life than those who had undergone MRM after one year from surgery (p=0.0149). Multivariate analysis revealed that five years from time of surgery, level of education and diabetes mellitus were significantly found to affect the quality of life of these patients. Male spouses had a general good quality of life. Conclusion: After one year from surgical management of early breast cancer, patients who had undergone BCS had a better quality of life as compared to MRM