Purpose. This prospective multicenter study explored different definitions of time to deterioration (TTD) in quality of life (QoL) scores, according to different cutoffs of the minimal clinically important difference (MCID) as a modality for longitudinal QoL assessment in breast cancer patients.Methods. QoL was assessed using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30 and BR-23 before surgery, after surgery, and 6 and 12 months later. The global health score, arm symptoms score (BRAS), and breast symptoms score were analyzed. For a given baseline score, QoL was considered to have deteriorated if this score decreased by >5 points at any time point after baseline. Analyses were repeated using an MCID of 10 points and taking the score after surgery as the reference score (to explore the occurrence of response shift). TTD was calculated using the Kaplan-Meier method and Cox regression was used to identify independent factors associated with TTD.Results. Two hundred thirty-five patients underwent axillary lymph node dissection (ALND), 222 underwent sentinel lymph node biopsy (SLNB), and 61 underwent SLNB plus ALND. Patients who underwent SLNB had a significantly longer TTD for the BRAS dimension than those who underwent ALND. Cox multivariate analyses showed that treatment using SLNB and age >59 years were independently associated with longer TTD for the

Aims: To evaluate the patients' satisfaction with breast reconstruction using the autologous latissimus dorsi technique and the impact of the procedure on the quality of life and body image of women who had mastectomy for breast cancer. were sent through the post following surgery. Methods Results:The overall response rate was 77% and the mean (MBROS-S) satisfaction score was 3.36. The quality of life (EORTC QLQ-C30, EORTC QLQ-BR23) in RW was no better than that in NRW, but body image was better (p=0.0247) especially before 60 years (p= 0.0192), in obese patients (p=0.03) and when the breasts of RW were heavy (p=0.0197). Moreover, when the time from the mastectomy was less than 4 years, body image (p=0.0008) and the sexual activity score (p= 0.0078) were higher in RW. Conclusions:The level of satisfaction was higher in RW, and breast reconstruction made a strong contribution in terms of improvement in body image. A prospective study to evaluate quality of life in the long term is now necessary. words

We present the clinical, radiological and pathological findings that led to the diagnosis.

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