Contributing factors affecting quality of life following breast cancer surgery: A 3-month prospective cohort study
Bibliographic record
Abstract
Aims: To assess the contributing factors associated with the quality of life (QoL) and its domains (Mental Component Summary, MCS, and Physical Component Summary, PCS) following breast cancer (BC) surgery, and to assess the association between chronic pain after breast cancer surgery (CPBCS) and QoL, both at three months.Methods: A prospective three-month cohort study was conducted among patients scheduled to undergo BC surgery at the Jewish General Hospital, Montreal, QC. Eligible participants were interviewed before surgery to assess their age, preoperative pain intensity, number of painful comorbidities, anxiety, depression and optimism. Telephone follow-up interviews were conducted seven days and three months after BC surgery to assess acute postoperative pain and CPBCS respectively, using Brief Pain Inventory (BPI). Intraoperative and postoperative data such as type of surgery, cancer grade, axillary status, surgery length, radiotherapy and chemotherapy were recorded from the physicians' charts. QoL was assessed by using Short Form health-related quality of life questionnaire (SF-12v2). Statistical analyses were performed using SAS 9.4 software, SAS Institute Inc., Cary, NC, USA.Results: Among 182 eligible participants, 156 (85.7%) completed the three-month follow-up. The principal findings for the multivariable linear regression analyses showed that anxiety (β= -5.29, 95% CI -10.34; -0.24), depression (β= -4.75, 95% CI -8.97; -0.53), preoperative pain intensity (β = -1.60, 95% CI -2.89; -0.32) contributed to a decrease in average MCS at three months, whereas optimism (β = 0.41, 95% CI 0.04; 0.78) contributed to increased average MCS. Increasing cancer grade contributed to a decrease in average MCS (= -10.96, 95% CI -20.69; -1.23) and PCS (= -5.33, 95% CI -10.42; -0.25). A borderline association was found between PCS and type of surgery (β = -4.52, 95% CI -9.73, 0.69). Chemotherapy was associated with a decrease in average PCS (= -4.54, 95% CI -8.05; -1.03). Age, surgery length, acute postoperative pain and radiotherapy were not related with either MCS or PCS. Intensity of CPBCS was negatively associated with PCS (= -0.17, 95%CI: -0.24; -0.09, P<0.0001) and MCS (= -0.11, 95%CI: -0.20; -0.02, P =0.02) regardless of relevant predictors associated with MCS and PCS.Conclusion: These study results demonstrated that PCS among the patient who underwent BC surgery was affected by cancer grade and chemotherapy, whereas psychological factors, cancer grade, and severity of preoperative pain had an impact on MCS. Increasing severity of CPBCS was associated with lower PCS and MCS. Therefore, these factors should be considered in the management of BC surgery patients to improve their QoL.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".