Factors affecting health-related quality of life following axillary lymph node dissection among breast cancer survivors in Egypt.
Horeya Mohamed Ismail, Mostafa Ahmed Arafa, Mohamed Mostafa Tahoun, Ahmed Nabil Shama, Amr Abdel Aziz Elsaid
Abstract
Open AccessAxillary lymph node dissection (ALND) remains a standard component in the management of breast cancer; however, it may have lasting impacts on patients' health-related quality of life (HRQOL). This study aimed to assess HRQOL and identify its demographic and clinical correlates among breast cancer survivors who underwent ALND. This cross-sectional study was conducted among breast cancer survivors post-ALND at a tertiary oncology center in Alexandria, Egypt. HRQOL was measured using the Arabic FACT-B (version 4.0), and the associated factors were analyzed using multivariate analysis of variance (MANOVA). A total of 150 breast cancer survivors completed the FACT-B questionnaire, with a mean HRQOL score of 88.92 ± 18.01. Of the participants, 18.7% had poor, 64.0% had moderate, and 17.3% had good HRQOL. MANOVA showed that the type of surgery, BMI, HER2 status, lymph node involvement, and tumor stage were significantly associated with HRQOL (p < 0.05). Between-subject analyses and post hoc comparisons confirmed significant group differences across the FACT-B subscales. Overweight or obese participants had poorer Physical, Emotional, and Functional Well-Being. Mastectomy, HER2-positive status, and Stage III disease were associated with lower HRQOL across multiple domains, while lymph node involvement impacted the Physical Well-Being subscale only. Integrating routine HRQOL assessment into survivorship care is essential for identifying individuals at a higher risk of poor outcomes. Tailored follow-up strategies and supportive interventions for these subgroups can enhance the long-term well-being and improve the overall post-treatment quality of life of breast cancer survivors.