Abstract P2-03-09: Breast Cancer Surgery and Its Quality-of-Life Outcomes: A Study of São Paulo Public Employees

Abstract Objective: To evaluate the quality of life (QoL) of breast cancer patients’ post-surgery, compare conservative, radical, and oncoplastic surgical outcomes, and identify symptoms and treatment-related factors that negatively impact QoL. Methods: This observational, cross-sectional, descriptive study was conducted at the Hospital do Servidor Público Estadual de São Paulo (HSPE) from October 2021 to December 2022. We assessed the QoL of female state public servants presenting in situ or non-metastatic invasive breast cancer who underwent surgical treatment and completed the EORTC QLQ-C30 questionnaire. Inclusion criteria encompassed female patients over 18 years, diagnosed with breast cancer, undergoing surgical treatment, employed as public servants in São Paulo, and actively working at diagnosis. Exclusion criteria included refusal to respond to the questionnaire and metastatic breast cancer at the study's outset or progression within six months of diagnosis. Ethical approval was obtained from the HSPE Research Ethics Committee (CAAE 68337823.4.0000.5463), and all participants signed informed consent forms. Results: The study included 300 patients with a mean age of 56.6 years. Most participants had a partner (55.69%) and higher education (72.15%). The EORTC QLQ-C30 scores indicated a reasonable overall quality of life, with an average score of 70.6. Physical (76.6), social (87.1), and role functioning (78.3) scored high. Most patients did not experience bed confinement, did not need assistance with daily activities, and were able to maintain their leisure activities. Emotional functioning had the lowest score (65.1), indicating some level of tension, irritability, depression, or worry. On the symptom scale, insomnia (33.3), pain (30.0), and fatigue (28.3) were the most prevalent, while nausea and vomiting (5.7), dyspnea (7.2), and diarrhea (8.0) scored low, suggesting little interference with daily activities. There was some financial difficulty due to the physical condition and treatment (15.6). In the QLQ-BR23, the score for side effects was 18.5, indicating few adverse effects from systemic treatments. Concerns about hair loss (35.9), arm symptoms (25.2), and breast symptoms (22.4) were the most affected. Body image acceptance was good (74.9), indicating that most patients did not feel less attractive or feminine. Sexual function scored high (82.5), but sexual satisfaction was lower (57.4), showing that although sexual activity continued, satisfaction was impaired. Patients who underwent conservative surgery had better overall quality of life (73.2) compared to radical (66.7) and oncoplastic surgery (55.2) (p=0.033). Cognitive function was better preserved in conservative surgery (79.5) compared to oncoplastic (56.3) (p=0.045). Social function was also better with conservative surgery (90.7) compared to oncoplastic (70.8) and radical (78.3) (p=0.017). More advanced clinical staging was negatively correlated with quality of life, especially in role functioning (p=0.006), social function (p=0.004), and body image (p=0.002). Patients with triple-negative tumors reported greater limitations in activities, while those with HER-2 expression had better role functioning scores (p=0.094). Neoadjuvant chemotherapy was associated with lower body image satisfaction (60.3 vs. 78.9; p=0.033) and greater concern about hair loss (58.3 vs. 30.1; p=0.014). Adjuvant radiotherapy was associated with better overall quality of life (73.0) and social function (89.3) scores (p=0.007 and p=0.033, respectively), as well as lower pain symptoms (8.5 vs. 25.0; p=0.007). Conclusion: Breast cancer patients demonstrated that while the overall quality of life was reasonable, emotional functioning remained a challenge. Conservative surgery yielded better outcomes in quality of life, cognitive, and social functions compared to radical and oncoplastic surgeries. Advanced clinical staging and triple-negative tumors were linked to greater limitations, whereas HER-2 positive patients showed better role functioning. Neoadjuvant chemotherapy negatively impacted body image and increased concern about hair loss, while adjuvant radiotherapy improved overall quality of life and reduced pain. These findings underscore the need for tailored supportive care to address the emotional and specific functional challenges faced by breast cancer patients. Citation Format: Marcelo Antonini, Andre Mattar, Mylena Scheneider Becale, Arthur Gaia Duarte Peixoto, Denise Joffily Pereira da Costa Pinheiro, Renata Arakelian, Felipe Zerwes, Eduardo de Camargo Millen, Francisco Pimentel Cavalcante, Antônio Luiz Frasson, Fabrício Palermo Brenelli, Odair Ferraro, Reginaldo Guedes Coelho Lopes. Breast Cancer Surgery and Its Quality-of-Life Outcomes: A Study of São Paulo Public Employees [abstract]. In: Proceedings of the San Antonio Breast Cancer Symposium 2024; 2024 Dec 10-13; San Antonio, TX. Philadelphia (PA): AACR; Clin Cancer Res 2025;31(12 Suppl):Abstract nr P2-03-09.