To study whether there is any difference in postoperative quality of life between breast cancer patients undergoing immediate breast reconstruction and breast mastectomy without breast reconstruction.

From November 2017 to November 2019, 150 breast cancer patients underwent modified radical mastectomy in the Department of Breast Cancer Surgery, the First Affiliated Hospital of Hainan Medical University. According to different operation method, the patients were divided into the immediate reconstruction group (radical + reconstruction group, n=25) and the mastectomy without immediate breast reconstruction group (total mastectomy group, n=125). According to the EORTC QLQ-BC45 (Quality of life questionnaire for assessing quality of life in breast cancer patient), the quality of life in two groups of patients was assessed 6 months after their surgeries. Another self-made breast cancer questionnaire was made to compare the life satisfaction of their spouses.

After the bias was eliminated by the propensity score, there were no significant differences in intraoperative blood loss, length of hospital stay, flap necrosis, drainage tube placement time, and infection. Immediate reconstruction group patients scored better in body image, sexual enjoyment, future expectations (P<0.05). The results of the self-made questionnaire analysis showed that the spouses of the immediate reconstruction group scored better than the spouses of the mastectomy without immediate breast reconstruction group in terms of the body image, self-function, and emotional family (P <0.05). Logistics regression analysis suggested that age and economic level were related to the quality of life of the two groups after surgery (P<0.05).

The quality of life of patients undergoing immediate breast reconstruction is better than those undergoing breast ablation. Satisfaction with family well-being is better than that of patients with mastectomy. Age, financial level and education level may influence the choice of breast cancer patients.