Early post-operative changes in quality of life and psychological symptoms after breast cancer surgery: the role of perceived pain, upper limb disability, and disease acceptance

Purpose: The present study aimed to evaluate changes in QoL and psychological symptoms (anxiety and depression) in women with BC between the first days (T0) and 1 month after surgery (T1). In addition, the study examined longitudinal associations of perceived pain, upper limb disability, and disease acceptance with QoL and psychological symptoms across T0 and T1. Methods: A prospective, observational cohort study was conducted on 101 women with BC. At T0 and T1, the EuroQol Five-Dimension Five-Level, the Hospital Anxiety and Depression Scale, the Numeric Rating Scale, the Quick Disability of the Arm, Shoulder and Hand, and an adapted version of the Chronic Pain Acceptance Questionnaire were administered. Data were analyzed using paired-samples t-tests and linear mixed models (LMMs). Results: The results showed increased QoL and decreased psychological symptoms between T0 and T1. The LMMs revealed that assessment time was not significantly associated with QoL and psychological symptoms once perceived pain, upper limb disability, and disease acceptance were considered. Notably, perceived pain and upper limb disability were negatively associated with QoL. In addition, upper limb disability was positively associated with depressive symptoms. Lastly, disease acceptance was negatively associated with both anxiety and depressive symptoms. Conclusion: Improvements in QoL and psychological symptoms may occur within the first month after BC surgery. At equivalent levels of perceived pain, upper limb disability, and disease acceptance, the timing of assessment seems to provide no additional information about QoL and psychological symptoms. The findings suggest the importance of timely, multidisciplinary rehabilitation care for women with BC during the early post-operative period.