PurposeTo explore the dynamic changes in Quality of Life (QoL), anxiety/depression status, and body image (BI) of women who received different types of breast cancer (BC) surgery within an 8-years follow-up period.MethodsWomen with major BC surgeries were invited to complete the World Health Organization Quality of Life–Brief (WHOQOL-BREF), the European quality of life five dimensions questionnaire (EQ-5D), and a body image scale within 8 years of surgery. Kernel smoothing methods were applied to describe dynamic changes in QoL, anxiety/depression, and BI at different time points. Linear mixed effects models were constructed to identify the interaction between time, different types of surgery, and the determinants of QoL in these patients.ResultsA total of 1,803 women who had undergone a mastectomy, a modified radical mastectomy (MRM), and breast reconstruction (BR) were included. The BR group exhibited a high QoL score of WHOQOL one to five years after surgery with some fluctuations. The MRM group had comparatively stable, low QoL scores of WHOQOL items and less depressed/anxious. BR group generally showed fluctuated, lower scores of BI two years after operation, but they exhibited more anxiety/depression status after five years. Medical comorbidities, the status of anxiety/depression, and BI were the major factors influencing all domains and items of the WHOQOL BREF.ConclusionWhile MRM may decrease the likelihood of depression in patients with BC and BR would significantly improve their QoL in the first 5 years. We recommend that these findings should be considered and discussed in the patient participatory decision-making for breast surgery.