Quality of life in patients with ductal carcinoma in situ of the breast treated with conservative surgery and postoperative irradiation

Aim of the study: To evaluate the quality of life (QL) in patients with duc tal carcinoma in situ of the breast treated with conservative surgery and p ostoperative irradiation. Material and methods: A self-completed questionnaire covering many disease- , symptom-, and treatment-specific issues was administered to 106 conservat ively treated patients affected by non-infiltrating breast cancer. The ques tionnaire was based on a series of 34 items assessing five main fields of p ost-treatment adjustment: physical well being, sexual adaptation, aesthetic outcome, emotional/psychological well being, relational behaviour. Further more, the patients were requested to evaluate the degree of information pro vided by the medical staff concerning surgical procedures and radiation the rapy, and to evaluate the effects of the treatment on their social and over all life. Results: The questionnaire was completed by 83 patients (78%), who had a me dian follow-up of 54.5 months. This final sample had a median age of 50 yea rs (range 29-88) at the time of treatment and 54 years (range 32-94) at the time of study. The patients claimed to be in good physical condition. Data relating to sexual life were provided by 93% of the sample. Some limitatio ns in sexuality, some interference with sexual desire, and some modificatio ns during intercourse were reported by 5, 6, and 5 patients, respectively. The subjective evaluations of the cosmetic results of the therapies were ge nerally good. Only 13 patients (16%) reported the perception of a worsened body image. Forty-six percent of the sample (38 patients) declared that the y felt tense, 48% (39 patients) nervous, 29% (38 patients) lonely, 59% (41 patients) anxious, and 41% (34 patients) depressed. Only seven patients (8% ) declared that the treatment had had a bad effect on their social life, an d 15 (18%) thought that their current life had been affected by the treatme nt. The amount of information received concerning the disease and treatment (surgery and radiotherapy) was considered sufficient by 79%, 75%, and 79% of the sample, respectively. Conclusions: This study revealed a good QL in patients treated with breast conservation and postoperative irradiation, with a preserved favourable bod y image and a lack of negative impact on sexuality. Radiation therapy did n ot lead to any significant additional problems capable of affecting the QL.