Patient Satisfaction and Quality of Life After Breast-Conserving Surgery and Intraoperative Radiotherapy in South African Breast Cancer Patients: A Cross Sectional Study

Abstract

Background: Breast-conserving surgery (BCS) combined with intraoperative radiotherapy (IORT) is an emerging treatment option for early-stage breast cancer. While its oncological outcomes have been well-studied, there is limited research on patient-reported satisfaction and quality of life (QoL) following IORT, particularly in South Africa. This study aims to assess patient satisfaction and QoL after IORT using the BREAST-Q Breast-Conserving Therapy (BCT) module. Methods: A cross-sectional study was conducted at Milpark Hospital, Johannesburg. Patients who underwent BCS with IORT from 2017 - June 2024 were invited to participate. The BREAST-Q BCT questionnaire was used to assess key QoL domains, including breast satisfaction, psychosocial well-being, sexual well-being, cancer worry, and radiation-related side effects. Statistical analyses, including descriptive statistics, and non-parametric comparisons, were performed in JASP. Results: There was a 42% response rate. Breast satisfaction scores were generally high, with most patients reporting favourable outcomes. Psychosocial well-being and sexual well-being showed moderate to low satisfaction levels, and cancer worry remained a prevalent concern. No significant differences were observed between patients receiving IORT alone versus those who received additional external beam radiation therapy (p > 0.05). Conclusion: The study is limited by its small sample size (n=55) and single-centre design, which may affect generalisability. Future multi-centre studies with larger cohorts are needed. These findings support the use of patient-reported outcome measures in evaluating breast cancer treatments and highlight the need for psychosocial interventions to improve long-term well-being.