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Quality of Life of Women after Mastectomy in Two Training Hospitals in the City of Douala, Cameroon

Author(s): Charlotte Nguefack Tchente, Jean Paul Ndamba Engbang, Christian Eyoum, Meguia Kamdem, Lucie Sorelle Lekuikeu Tchuinte, Albertine Eloundou, Henri Essome, Michel Ekono, Pierre Marie Tebeu, Emile Tele

Introduction: Breast cancer is the most common cancer in women worldwide. In Cameroon, several women with breast cancer have gone through mastectomy for treatment. They face some difficulties living in society and within their couple with only one breast. The aim of this study was to describe the quality of life (QOL) of women after mastectomy in two hospitals in Douala.

Methods: This was a cross-sectional study carried out in two healthcare facilities over 4 months. Data from 102 consenting patients with unilateral mastectomy was collected. A survey sheet was used to collect patient socio-demographic, clinical, therapeutic data and data on QOL. We evaluated the QOL using questions from the various recognized questionnaires (EORTC QLQ-BR45, WHOQOL-BREF, FACT-MBIS and FACT-B) which we adapted according to our context. Chi-squared and Fisher tests allowed us to assess the association between variables. Statistical significance was set at p <0.05.

Results: The mean age at mastectomy was 48.2 ± 10years and 54.4% were married. Clinically, patients with a tumor size more than 5cm and inflammatory tumors were most represented (76.3%); 89.1% had lymph node involvement and 16.1% were metastatic at diagnosis. Other treatments received include chemotherapy (93%), radiotherapy (32.3%) and hormone therapy (22.1%). The overall QOL was impaired. Using a mean score on a scale of 0 to 4, physical (0.3), social (0.5), and sexual (1.2) QOL were less impaired than emotional (1.5), functional (2.7), and psychological (3) QOL. Factors associated with impaired physical QOL included young age (OR:6.11[2-18.58]; p:0.00007), being single (OR:3.1 [1.2-7.7]; p:0.01), tumor size between 2 and 5cm (OR:4.97[2-12.4]; p:0.0002). Those associated with the deterioration in overall QOL included delayed diagnosis and mastectomy (OR:16.60[1.61-170.45]; p:0.008).

Conclusion: The overall quality of life was impaired in all patients. Thus, patients undergoing mastectomy should benefit from pre- and postoperative psychological care.

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