Health-related quality of life and psychosocial functioning in women undergoing breast cancer surgery: insights from a longitudinal study in Cyprus

Abstract

The increasing incidence of breast cancer, coupled with high survival rates in Cyprus, highlights the necessity of addressing long-term survivorship and health-related quality of life (HRQoL) outcomes. HRQoL is a valuable metric for evaluating the impact of surgical interventions in breast cancer, including mastectomy (M), mastectomy with breast reconstruction (MBR), and breast conserving surgery (BCS). This study primarily sought to compare HRQoL among women diagnosed with breast cancer and scheduled for surgery in Cyprus with established reference values and to explore factors associated with HRQoL at diagnosis. An exploratory multi-centre longitudinal study was conducted involving 77 participants, who completed self-reported measures assessing sociodemographic characteristics, illness perceptions, personality traits, mood, coping, and HRQoL (measured using the EORTC QLQ-C30, v3 & EORTC QLQ-BR23), prior to surgery and approximately 7.5 months after surgery ( n  = 46 at follow-up). Statistical analyses included analysis of variance (ANOVA), one-sample t-tests, exploratory multiple regression analyses, and multilevel modelling. Participants had a mean age of 57.9 years (SD = 14.3), with the majority (62%) undergoing BCS. Overall, HRQoL levels were generally favourable and, in some domains, exceeded established reference values. A total of 51% of women experienced at least mild depressive symptomatology at diagnosis and 41% following their surgery. Depression and negative illness identity (i.e., attributing more symptoms to breast cancer) were significantly associated with multiple HRQoL outcomes at diagnosis (β range = − 0.57 to 0.65). Despite its methodological limitations, this is the first exploratory study to investigate HRQoL in Cypriot women with breast cancer undergoing surgery. The hypothesis-generating findings are the first step for future confirmatory research in larger Cypriot samples and support the importance of introducing routine assessments of patient-reported outcome measures (PROMs) throughout the breast cancer care pathway to ensure prompt identification and referral of women requiring psychological support.