Quality of Life After Modified Radical Mastectomy (MRM): A Prospective Study Using the European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30 and QLQ-BR45

Background: Modified radical mastectomy (MRM) remains a frequently performed operation for breast cancer, particularly where breast conservation is not feasible.Although it achieves reliable locoregional control, MRM is associated with lasting effects on physical function, body image, and psychosocial wellbeing.As survival improves, patient-reported quality of life (QoL) has become an essential survivorship outcome.This study assessed QoL after MRM using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30) and the breast-specific QLQ-BR45, complemented by the Unconditional Self-Acceptance Questionnaire (USAQ), and examined how QoL domains are associated with patient age.Methods: In this prospective observational study, 70 women who underwent MRM for invasive breast carcinoma at a tertiary-care institute were followed serially (diagnosis, postoperative Day 1, Day 7, one month, and six months); QoL questionnaires were completed at the six-month visit and scored according to the EORTC scoring manuals.Scores were compared across five age strata (≤39, 40-49, 50-59, 60-69, and ≥70 years) using one-way analysis of variance (ANOVA) with eta-squared (η 2 ), confirmed with the Kruskal-Wallis test, and adjusted for multiple testing (Benjamini-Hochberg false discovery rate, or FDR).Domains that differed by age were examined with multivariable regression adjusting for stage, neoadjuvant chemotherapy, and radiotherapy.Results: The mean age was 51.59±11.71years; most women had T2 (n=48, 68.6%), node-negative (n=39, 55.7%), non-metastatic (n=67, 95.7%) disease.Severe postoperative pain occurred in 98.6% (n=69), and the mean hospital stay was 13.66±2.26days.The QLQ-C30 summary score was 74.34±11.84and the USAQ score 76.79±4.05.After FDR correction on both ANOVA and Kruskal-Wallis testing, fatigue (η 2 =0.21), appetite loss (η 2 =0.18), body image (η 2 =0.49), future perspective (η 2 =0.22), arm (η 2 =0.19), breast (η 2 =0.18), endocrine therapy (η 2 =0.23), and endocrine sexual (η 2 =0.52) symptoms differed by age.Women aged 49 years or younger had poorer body image, whereas symptom scores were higher from age 50.All 11 women aged ≤39 years and 10 of 19 aged 40-49 years were sexually active, versus none of the 40 women aged 50 years or above.Age remained associated with all eight scales after adjustment, and stage III-IV disease was independently associated with poorer global health status (β=-8.29,p=0.004).USAQ scores did not vary with age (p=0.106).Conclusions: In this single-centre cohort, QoL six months after MRM was multidimensional and associated with age and disease stage.Younger women reported poorer body image and future perspective, while older women and those with advanced disease reported a heavier symptom burden.These exploratory findings suggest that body image, sexual health, arm morbidity, and symptom control may warrant attention in postmastectomy care, and they need confirmation in larger studies.