Patients younger than 40 who elected to have breast-conserving surgery instead of mastectomy to remove breast cancer reported having better quality of life (QOL) more than five years after diagnosis, according to study findings reported in JAMA Surgery.

Researchers surveyed 560 patients aged 17–40 who underwent surgical treatment for stage 0–II breast cancer: 290 patients (52%) received bilateral mastectomy, 110 patients (20%) had unilateral mastectomy, and 160 patients (28%) received breast-conserving therapy. Among patients undergoing either type of mastectomy, 357 (89%) had reconstruction.

Patients received the survey an average of 5.8 years after their diagnosis and answered questions across physical, psychosocial, and sexual well-being domains. For example, questions about breast satisfaction asked how well their breasts match, how they feel to the touch, and how they look in and out of clothing. Other questions assessed patients’ confidence in social settings, emotional health, and self-esteem.

Overall, patients receiving breast-conserving surgery reported higher satisfaction across all domains and those receiving bilateral mastectomy the lowest. The researchers found the strongest association with decreased breast satisfaction in patients who had implant-based breast reconstruction and the strongest association with worse physical well-being in patients who received complex reconstruction.

“Surgical choices that women with breast cancer make can have an impact on their long-term QOL,” the researchers said. “As clinicians, we need to have conversations with our patients about the surgical options so that we can help them understand how the treatment they choose might affect their QOL.”

Oncology nurses can help patients understand all considerations and implications for their treatment to make informed decisions. Learn how to use pre- and post-patient education assessments on the Oncology Nursing Podcast Episode 197: Patient Learning Needs and Educational Assessments.