Qualidade de vida das mulheres submetidas à mastectomia em uma cidade da região Norte do Brasil

Abstract

Breast cancer is associated with numerous repercussions in the woman's life, from diagnosis to post treatment, affecting an organ full of meanings. The purpose of this investigation is to evaluate the quality of life (QOL) of women with breast cancer who underwent mastectomy and to correlate it with the sociodemographic and clinical profile. Descriptive, documentary, transversal and quantitative study. The population consisted of 57 women attended at the High Complexity Unit in Oncology of Macapá-Amapá, from 2014 to 2018. The questionnaires QLQ-C30 and QLQ-BR23 were used at the interviewees' homes. For data analysis, the Statistical Package for Social Science (SPSS), version 24 Windows was used. The participants had an average age of 52.4 years, with a predominance of 82.5% of mixed race, 57.9% Catholic and 36.8% high school education, with the majority (49.4%) from the State of Amapá. As for the economic situation, 35.1% lived on two minimum wages, 57.9% did not work and 59.6% received Social Security benefits. With partners, they were 56.1%, and 75.5% had two or more children. 54.4% lived in residences with three or four people. The predominant type of surgery was total mastectomy, with 64.9% and lymphodectomy 70.1%. The average time to perform the surgery was two years and one month and the therapy most associated with the surgery was chemotherapy (73.6%), however, 82.5% did not undergo breast reconstruction. Multiprofessional follow-up: 71.9% were assisted by a nutritionist, 57.9% psychologist and 84.2% physiotherapist. QL characterization: in the QLQ-C30 instrument, there was a moderate global QOL of 62.3 ± (19.6). Most affected domains: performance of functions 55.6 ± (31.2), emotional function 61.3 ± (32.4) and cognitive function (62). Most common symptoms: financial difficulties, due to 64.9 ± (33.6), pain 38.6 ± (28.2) and fatigue 35.1 ± (28.7). In the QLQ-BR23, there was a decrease in sexual function 21.1 ± (21.5), sexual satisfaction 42 ± (23.7) and prospects for the future 49.1 ± (37.3), indicating a tendency towards QoL impairment. The symptom scale was low, the most common were hair loss 34.7 ± (33.3) and symptoms in the breasts 33.5 ± (30.0). Young mastectomized women had worse scores on the functional scale related to body image (p: 0.004); there was a significant association of women with a partner and sexual function (p = 0.024), with a tendency for better QOL for those without a partner, and the financial toxicity caused by the treatment was greater among women with low income (p = 0.004). Quadrandectomy was significantly better in physical functions (p = 0.024) and function performance (p = 0.015), compared to total mastectomy, which presented greater financial difficulties related to treatment (p = 0.006). Women with breast reconstruction had better sexual function (p = 0.028) compared to those who did not perform it. In turn, length of surgery, follow-up with a psychologist and physiotherapist had no significance level. Thus, the participants presented moderate QOL when QLQ-C30 was applied and great compromise in QLQ BR23, especially in sexuality.