Skip to main content

Quality of Life Among Women Treated for Breast Cancer: A Survey of Three Procedures in Mexico



This study aimed to determine the quality of life among patients treated with one of three different types of surgery for breast cancer.


This cross-sectional study used a questionnaire survey completed by Mexican patients without active disease 1 year after breast cancer surgery.


The 139 patients enrolled in the study included 44 (31.6 %) who had undergone mastectomy with reconstruction, 41 (29.5 %) who had undergone a quadrantectomy, and 54 (38.9 %) who had undergone radical mastectomy without reconstruction. The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire, core version 30 (EORTC QLQ-C30) and EORTC Breast Quality-of-Life Questionnaire (QLQ-BR23) questionnaires were used. These instruments had a reliability greater than 0.82. Global health status (94.30 ± 12.04; p = 0.028) and role functioning (85.16 ± 17.23; p = 0.138) were highest in the quadrantectomy group. The pain score was highest in the group that had received mastectomy with reconstruction (26.13 ± 30.15; p = 0.042). The breast symptom score (22.56 ± 22.30; p = 0.009) and body image perception (85.56 ± 19.72; p = 0.025) were highest in the group that had conservative treatment. The overall health of the patients who had undergone mastectomy without reconstruction was lower (72.61 ± 20.89; p = 0.014) among the women older than 50 years than among the younger women.


The quadrantectomy procedure had better acceptance, but the overall health status did not differ between the groups. The overall health status was lower among the women older than 50 years who had received a mastectomy without reconstruction.

Level of Evidence V

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors

This is a preview of subscription content, access via your institution.


  1. 1.

    Snyder CF, Aaronson NK (2009) Use of patient-reported outcomes in clinical practice. Lancet 374:369–370

    PubMed  Article  Google Scholar 

  2. 2.

    Greenhalgh J (2009) The applications of PROs in clinical practice: what are they, do they work, and why? Qual Life Res 18:115–123

    PubMed  Article  Google Scholar 

  3. 3.

    Velikova G, Booth L, Smith AB, Brown PM, Lynch P, Brown JM, Selby PJ (2004) Measuring quality of life in routine oncology practice improves communication and patient well-being: a randomized controlled trial. J Clin Oncol 22:714–724

    PubMed  Article  Google Scholar 

  4. 4.

    Berry DL, Blumenstein BA, Halpenny B, Wolpin S, Fann JR, Austin-Seymour M, Bush N, Karras BT, Lober WB, McCorkle R (2011) Enhancing patient–provider communication with the electronic self-report assessment for cancer: a randomized trial. J Clin Oncol 29:1029–1035

    PubMed  Article  PubMed Central  Google Scholar 

  5. 5.

    Santana MJ, Feeny D, Johnson JA, McAlister FA, Kim D, Weinkauf J, Lien DC (2010) Assessing the use of health-related quality-of-life measures in the routine clinical care of lung-transplant patients. Qual Life Res 19:371–379

    PubMed  Article  Google Scholar 

  6. 6.

    Detmar SB, Muller MJ, Schornagel JH, Wever LD, Aaronson NK (2002) Health-related quality-of-life assessments and patient-physician communication: a randomized clinical trial. JAMA 288:3027–3034

    PubMed  Article  Google Scholar 

  7. 7.

    Greenhalgh J, Meadows K (1999) The effectiveness of the use of patient-based measures of health in routine practice in improving the process and outcomes of patient care: a literature review. J Eval Clin Pract 5:401–416

    PubMed  Article  CAS  Google Scholar 

  8. 8.

    Marshall S, Haywood K, Fitzpatrick R (2006) Impact of patient-reported outcome measures on routine practice: a structured review. J Eval Clin Pract 12:559–568

    PubMed  Article  Google Scholar 

  9. 9.

    Haywood K, Marshall S, Fitzpatrick R (2006) Patient participation in the consultation process: a structured review of intervention strategies. Patient Educ Couns 63:12–23

    PubMed  Article  Google Scholar 

  10. 10.

    Cleeland CS, Wang XS, Shi Q, Mendoza TR, Wright SL, Berry MD, Malveaux D, Shah PK, Gning I, Hofstetter WL, Putnam JB Jr, Vaporciyan AA (2011) Automated symptom alerts reduce postoperative symptom severity after cancer surgery: a randomized controlled clinical trial. J Clin Oncol 29:994–1000

    PubMed  Article  PubMed Central  Google Scholar 

  11. 11.

    McLachlan SA, Allenby A, Matthews J, Wirth A, Kissane D, Bishop M, Beresford J, Zalcberg J (2001) Randomized trial of coordinated psychosocial interventions based on patient self-assessments versus standard care to improve the psychosocial functioning of patients with cancer. J Clin Oncol 19:4117–4125

    PubMed  CAS  Google Scholar 

  12. 12.

    The European Organization for Research and Treatment of Cancer: Quality of Life Questionnaire (EORTC QLQ-C30), version 3.0. URL: Retrieved 5 August 2013

  13. 13.

    The European Organization for Research and Treatment of Cancer: Breast Quality-of-Life Questionnaire (EORTC QLQ-BR23). Retrieved 5 August, 2013

  14. 14.

    Oñate-Ocaña LF, Alcántara-Pilar A, Vilar-Compte D, García-Hubard G, Rojas-Castillo E, Alvarado-Aguilar S, Carrillo JF, Blazeby JM, Aiello-Crocifoglio V (2009) Validation of the Mexican Spanish version of the EORTC C30 and STO22 questionnaires for the evaluation of health-related quality of life in patients with gastric cancer. Ann Surg Oncol 16:88–95

    PubMed  Article  Google Scholar 

  15. 15.

    Cerezo O, Oñate-Ocaña LF, Arrieta-Joffe P, González-Lara F, García-Pasquel MJ, Bargalló-Rocha E, Vilar-Compte D (2012) Validation of the Mexican-Spanish version of the EORTC QLQ-C30 and BR23 questionnaires to assess health-related quality of life in Mexican women with breast cancer. Eur J Cancer Care 21:684–691

    Article  CAS  Google Scholar 

  16. 16.

    Monteiro-Grillo I, Marquez-Vidal P, Jorge M (2005) Psychosocial effect of mastectomy versus conservative surgery in patients with early breast cancer. Clin Transl Oncol 7:499–503

    PubMed  Article  Google Scholar 

  17. 17.

    Medina-Franco H, García-Alvarez MN, Rojas-García P, Trabanino C, Drucker-Zertuche M, Arcila D (2010) Body image perception and quality of life in patients who underwent breast surgery. Am Surg 76:1000–1005

    PubMed  Google Scholar 

  18. 18.

    Arraras Urdaniz JI, Illarramendi Mañas JJ, Manterola Burgaleta A, Tejedor Gutiérrez M, Vera García R, Valerdi Alvarez JJ, Domínguez Domínguez MA (2003) Evaluation through the EORTC questionnaires of long-term quality of life in patients with breast cancer in initial stages. Rev Clin Esp 203:577–581

    PubMed  Article  CAS  Google Scholar 

  19. 19.

    Montazeri A (2008) Health-related quality of life in breast cancer patients: a bibliographic review of the literature from 1974 to 2007. J Exp Clin Cancer Res 27:32

    PubMed  Article  PubMed Central  Google Scholar 

  20. 20.

    Arndt V, Merx H, Stegmaier Ch, Ziegler H, Brenner H (2005) Persistence of restrictions in quality of life from the first to the third year after diagnosis in women with breast cancer. J Clin Oncol 23:445–453

    Article  Google Scholar 

  21. 21.

    Groenvold M, Petersen MA, Idler E, Bjorner JB, Fayers PM, Mouridsen HT (2007) Psychological distress and fatigue predicted recurrence and survival in primary breast cancer patients. Breast Cancer Res Treat 105:209–219

    PubMed  Article  Google Scholar 

  22. 22.

    Hormes JM, Lytle LA, Gross CR, Ahmed RL, Troxel AB, Schmitz KH (2008) The Body Image and Relationships Scale: development and validation of a measure of body image in female breast cancer survivors. J Clin Oncol 26:1269–1274

    PubMed  Article  Google Scholar 

  23. 23.

    Gordon LG, Battistutta D, Scuffham P, Tweeddale M, Newman B (2005) The impact of rehabilitation support services on health-related quality of life for women with breast cancer. Breast Cancer Res Treat 93:217–226

    PubMed  Article  Google Scholar 

  24. 24.

    Ferlay J, Shin HR, Bray F, et al: GLOBOCAN 2008 v3.0. Cancer Incidence, Mortality, and Prevalence Worldwide: IARC Cancer Base No. 10. Available from Retrieved 10 August 2013

  25. 25.

    Rodríguez-Cuevas S, Guisa-Hohenstein F, Labastida-Almendaro S (2009) First breast cancer mammography screening program in Mexico: initial results 2005–2006. Breast J 15:623–631

    PubMed  Article  Google Scholar 

  26. 26.

    Gómez-Dantés O, Sesma S, Becerril VM, Knaul FM, Arreola H, Frenk J (2011) The health system of Mexico. Salud Publica Mex 53:s220–s232

    PubMed  Google Scholar 

  27. 27.

    Arce-Salinas C, Lara-Medina FU, Alvarado-Miranda A, Castañeda-Soto N, Bargalló-Rocha E, Ramírez-Ugalde MT, Pérez-Sánchez V, Rivera L, Gambo-Vignole C, Santamaría-Galicia J, Nieves-Casas RI, Morán-Muñoz H, Mohar-Betancourt A (2012) Evaluation of breast cancer treatment at a tertiary-level institution with Popular Health Insurance in Mexico. Rev Invest Clin 64:9–16

    PubMed  Google Scholar 

  28. 28.

    Ganz PA, Desmond KA, Leedham B, Rowland JH, Meyerowitz BE, Belin TR (2002) Quality of life in long-term, disease-free survivors of breast cancer: a follow-up study. J Natl Cancer Inst 94:39–49

    PubMed  Article  Google Scholar 

  29. 29.

    Engel J, Kerr J, Schlesinger-Raab A, Sauer H, Hölzel D (2004) Quality of life following breast-conserving therapy or mastectomy: results of a 5-year prospective study. Breast J 10:223–231

    PubMed  Article  Google Scholar 

  30. 30.

    Bloom JR, Petersen DM, Kang SH (2007) Multi-dimensional quality of life among long-term (5 + years) adult cancer survivors. Psychooncology 16:691–706

    PubMed  Article  Google Scholar 

  31. 31.

    Peuckmann V, Ekholm O, Rasmussen NK, Møller S, Groenvold M, Christiansen P, Eriksen J, Sjøgren P (2007) Health-related quality of life in long-term breast cancer survivors: nationwide survey in Denmark. Breast Cancer Res Treat 104:39–46

    PubMed  Article  Google Scholar 

  32. 32.

    Koch L, Jansen L, Herrmann A, Stegmaier C, Holleczek B, Singer S, Brenner H, Arndt V (2013) Quality of life in long-term breast cancer survivor: a 10-year longitudinal population-based study. Acta Oncol 52:1119–1128

    PubMed  Article  Google Scholar 

  33. 33.

    Soto-Caceres R, Soto-Casares V (2013) Level of quality of life perception in patients with and without breast cancer radical surgery at the National Hospital Almanzor Aguinaga, Chiclayo. Rev Cuerpo Med HNAAA 6:25–29

    Google Scholar 

  34. 34.

    Basson R (2006) Clinical practice: sexual desire and arousal disorders in women. N Engl J Med 354:1497–1506

    PubMed  Article  CAS  Google Scholar 

  35. 35.

    Rosen R, Brown C, Heiman J, Leiblum S, Meston C, Shabsigh R, Ferguson D, D’Agostino R Jr (2000) The female sexual function index (FSFI): a multidimensional self-report instrument for the assessment of female sexual function. J Sex Marital Ther 26:191–208

    PubMed  Article  CAS  Google Scholar 

  36. 36.

    Neto MS, de Aguiar Menezes MV, Moreira JR, Garcia EB, Abla LE, Ferreira LM (2013) Sexuality after breast reconstruction for mastectomy. Aesthetic Plast Surg 37:643–647

    PubMed  Article  Google Scholar 

  37. 37.

    Alderman AK, Wilkins EG, Lowery JC, Kim M, Davis JA (2000) Determinants of patient satisfaction in postmastectomy breast reconstruction. Plast Reconstr Surg 106:769–776

    PubMed  Article  CAS  Google Scholar 

Download references


The Research Ethics Committee of Onkos Oncology Clinics funded the project.

Conflict of interest

All the authors declare no conflict of financial interest.

Author information



Corresponding author

Correspondence to Alejandro González-Ojeda.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Cortés-Flores, A.O., Morgan-Villela, G., del Valle, C.J.ZF. et al. Quality of Life Among Women Treated for Breast Cancer: A Survey of Three Procedures in Mexico. Aesth Plast Surg 38, 887–895 (2014).

Download citation


  • Breast cancer
  • Mastectomy without reconstruction
  • Mastectomy with reconstruction
  • Quadrantectomy
  • Quality of life