Significant advances in the diagnosis and treatment of breast cancer have led to an increase in patient survival. However, the treatment of breast cancer often involves a multimodal approach with surgeries and adjuvant therapies, which still have adverse effects that can affect several domains of quality of life (QoL) in the short and long term. Understanding the effects of breast cancer treatment on the QoL of these women is essential for the development of therapeutic interventions that address the needs of this population.

To assess the impact of surgical treatment on the QoL of women with breast cancer and the factors associated with a greater impact on QoL.

This is an observational study with a quantitative approach, carried out in Fortaleza/CE. Women between 18 and 80 years old, between 3 and 12 months after surgery for breast cancer and under outpatient follow-up, from May 2022 to March 2023 were included. Those with cognitive impairment assessed by the Mini-Mental State Examination (MMSE) were excluded. Sociodemographic and clinical data were collected, and the Functional Assessment of Cancer Therapy-Breast questionnaire (FACT-B+4) was applied through interviews to assess QoL. The Fact-B+4 score ranges from 0 to 164, in which the higher the score, the better the quality of life. The score is also evaluated in the following domains: Physical Well-being (PWB), Social/Family Well-being (SWB), Emotional Well-being (EWB), Functional Well-being (FWB), Breast Cancer Subscale (BCS) and Arm Subscale (ARM). For analysis of associations, Student's t test was used, assuming p< 0.05 for significance.

29 women with a mean age of 55.9±10.2 years were included. The mean FACT-B+4 total score was 104.3±16.9. The most impacted domains were ARM (16.3±3.6), FWB (17.5±4.2) and EWB (18.2±4.9). There was an association between postmenopausal status and lower scores in the EWB (p<0.01), FWB (p<0.01), PWB (p<0.01) and ARM (p=0.018) domains. Age (<60 years) was associated only with the ARM domain (p=0.03). Adjuvant therapy, through radiotherapy and hormone therapy, was associated with lower FWB scores (p=0.03; p=0.01 respectively), while chemotherapy was associated with lower EWB scores (p=0.01). There was no association between the surgical type and the axillary approach in the sample's QoL scores.

The FWB, EWB and ARM domains were the most affected after breast cancer treatment, which may be related to impaired self-image, autonomy and performance of activities of daily living. Age, menopausal status, and adjuvant therapy are associated with different impacts on QoL in this population.

Considering the multiplicity of factors that impact the QoL of women operated on for breast cancer is extremely important for the development of assistance and support strategies during the oncological treatment process, not only after surgery, but in the long-term during adjuvant therapy.