This prospective observational study evaluated early post-operative changes in quality of life (QoL) and psychological symptoms in women undergoing surgery for breast cancer. The investigators sought to compare patient-reported QoL, anxiety, and depressive symptoms between the first days after surgery (T0) and one month later (T1). A secondary objective was to examine longitudinal associations of perceived pain, upper limb disability, and disease acceptance with QoL and psychological symptoms across the two time points.
The cohort comprised 101 women with breast cancer enrolled in a prospective observational study. Assessments occurred at two time points: the immediate post-operative period (described as the first days after surgery, T0) and at one month after surgery (T1). Patient-reported outcome instruments administered at both time points included:
The study was observational in design and focused on patient-reported outcomes in the early post-operative interval following breast cancer surgery.
Group-level changes between T0 and T1 were examined using paired-samples t-tests. To investigate longitudinal associations while accounting for within-subject correlation and repeated measures, the authors used linear mixed models (LMMs). The LMMs evaluated whether assessment time (T0 vs T1) remained associated with QoL and psychological symptoms after including perceived pain, upper limb disability, and disease acceptance as predictors.
At the group level, patients reported an increase in quality of life and a decrease in psychological symptoms (both anxiety and depressive symptoms) from the first days after surgery (T0) to one month post-operatively (T1). These paired-samples comparisons indicate early improvement in both QoL and mood during the first post-operative month in this cohort.
When predictors were included in the linear mixed models, the assessment time point (T0 vs T1) was no longer significantly associated with QoL or psychological symptoms. Instead, three patient-reported factors accounted for outcome variability across time:
These model results imply that, at equivalent levels of pain, arm disability, and acceptance, the timing of assessment (immediate post-operative vs one month) did not provide additional explanatory value for QoL or mood outcomes.
The study demonstrates that measurable improvements in QoL and reductions in anxiety and depressive symptoms can occur within the first month after breast cancer surgery. However, the modeling indicates that patient-reported factors—perceived pain, upper limb disability, and disease acceptance—are key drivers of QoL and psychological symptoms in this early period. These findings support the clinical importance of early, multidisciplinary rehabilitation strategies that target pain management, restoration of upper limb function, and interventions to enhance acceptance and coping.
Potential clinical actions informed by these results include timely assessment of pain and arm function after surgery, early referral to physiotherapy or occupational therapy for upper limb rehabilitation, and consideration of psychoeducational or acceptance-oriented interventions to reduce anxiety and depressive symptoms.
The study was conducted in accordance with the Declaration of Helsinki and received approval from a Territorial Ethics Committee (protocol number 53-2023). Informed consent was obtained from participants. The abstract reports main results and model-level associations but does not provide detailed numeric effect sizes, confidence intervals, or full model coefficients in the abstract; those specifics were not reported in the source abstract. The authors conclude that early post-operative improvements in QoL and psychological symptoms are observable within one month, and that monitoring and addressing pain, upper limb disability, and disease acceptance are important components of early post-operative care for women with breast cancer.