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Purpose <p>To examine age-stratified changes in patient-reported health-related quality of life (HRQoL) following breast cancer surgery across surgical modalities.</p> Methods <p>In this prospective cohort study, 471 breast cancer patients undergoing breast-conserving surgery (BCS), total mastectomy no reconstruction (TMNR), or mastectomy with immediate breast reconstruction (MIBR) completed validated breast cancer-specific and general patient-reported outcome measures preoperatively and six months postoperatively. Patients were stratified into three age categories (≤ 49, 50–69, ≥ 70 years). The primary outcome was postoperative BREAST-Q breast satisfaction. Multivariable linear regression evaluated associations between age category and six-month postoperative scores, adjusting for surgical modality and patient characteristics.</p> Results <p>Surgical modality, rather than age category, was independently associated with postoperative breast satisfaction. Compared with BCS, TMNR was associated with significantly lower breast satisfaction (β = −13.47, <i>p</i> &lt; 0.01) and lower physical and sexual well-being, whereas MIBR demonstrated comparable breast satisfaction but lower physical chest well-being. Older age category was independently associated with higher postoperative psychosocial, chest physical well-being and perceived health, as well as lower anxiety, depression, and pain. Surgical modality was not associated with postoperative depression, anxiety, pain, or perceived health.</p> Conclusion <p>Surgical modality determined postoperative breast satisfaction, with TMNR associated with worse breast-specific outcomes compared with BCS across age categories. Psychosocial and symptom-related outcomes instead varied significantly by age, with older patients reporting higher well-being and lower symptom burden. These findings support age-informed surgical counseling and targeted supportive care strategies.</p>

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Age-stratified difference in patient-reported health-related quality of life following breast cancer surgery

  • 期刊论文

  • 发表日期：

    2026年7月10日

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  • Claire Liu,
  • Rebecca Warburton,
  • Jin-Si Pao,
  • Carol K. Dingee,
  • Amy Bazzarelli,
  • Guiping Liu,
  • Trafford Crump,
  • Jason Sutherland,
  • Elaine C. McKevitt

摘要

Purpose

To examine age-stratified changes in patient-reported health-related quality of life (HRQoL) following breast cancer surgery across surgical modalities.

Methods

In this prospective cohort study, 471 breast cancer patients undergoing breast-conserving surgery (BCS), total mastectomy no reconstruction (TMNR), or mastectomy with immediate breast reconstruction (MIBR) completed validated breast cancer-specific and general patient-reported outcome measures preoperatively and six months postoperatively. Patients were stratified into three age categories (≤ 49, 50–69, ≥ 70 years). The primary outcome was postoperative BREAST-Q breast satisfaction. Multivariable linear regression evaluated associations between age category and six-month postoperative scores, adjusting for surgical modality and patient characteristics.

Results

Surgical modality, rather than age category, was independently associated with postoperative breast satisfaction. Compared with BCS, TMNR was associated with significantly lower breast satisfaction (β = −13.47, p < 0.01) and lower physical and sexual well-being, whereas MIBR demonstrated comparable breast satisfaction but lower physical chest well-being. Older age category was independently associated with higher postoperative psychosocial, chest physical well-being and perceived health, as well as lower anxiety, depression, and pain. Surgical modality was not associated with postoperative depression, anxiety, pain, or perceived health.

Conclusion

Surgical modality determined postoperative breast satisfaction, with TMNR associated with worse breast-specific outcomes compared with BCS across age categories. Psychosocial and symptom-related outcomes instead varied significantly by age, with older patients reporting higher well-being and lower symptom burden. These findings support age-informed surgical counseling and targeted supportive care strategies.