Breast Cancer Research and Treatment 56: 45–57, 1999. © 1999 Kluwer Academic Publishers. Printed in the Netherlands. Report Quality of life in the first year after breast cancer surgery: rehabilitation needs and patterns of recovery Kojiro Shimozuma 1 , Patricia A. Ganz 2,3 , Laura Petersen 2 , and Karim Hirji 4 1 Department of Surgery, Breast and Thyroid Division, Kawasaki Medical School, Kurashiki–City, Japan; 2 Division of Cancer Prevention and Control Research, Jonsson Comprehensive Cancer Center at UCLA, Los Angeles, CA; 3 Schools of Medicine and Public Health, UCLA, Los Angeles, CA; 4 Department of Biomathematics, UCLA School of Medicine, and the BASE Unit, Jonsson Comprehensive Cancer Center, Los Angeles, CA Key words: breast cancer, psychological distress, quality of life, rehabilitation needs Summary Background. Although mortality rates from breast cancer are declining, many breast cancer survivors will experi- ence physical and psychological sequelae that affect their everyday lives. Few prospective studies have examined the rehabilitation needs of newly diagnosed breast cancer patients, and little is known about the predictors of health-related quality of life (QOL) in this population. Methods. Between 1987 and 1990, 227 women with early stage breast cancer participated in a prospective longitudinal study in which detailed information was collected through interviews, standardized measures of QOL and psychological distress, and clinical evaluation. Comparisons of physical and treatment-related problems were made according to type of surgical treatment. Multivariate regression analysis was performed to examine the predictors of QOL at one year after surgery. Results. Physical and treatment-related problems were reported frequently one month after breast cancer sur- gery, and occurred with equal frequency in women receiving modified radical mastectomy or breast conservation treatment. There were no significant differences in problems reported at one year by type of surgery; however, frequently reported problems include ‘numbness in the chest wall or axilla,’ ‘tightness, pulling or stretching in the arm or axilla,’ ‘less energy or fatigue,’ ‘difficulty in sleeping,’ and ‘hot flashes’. There was no relationship between the type of surgery and mood or QOL. Poorer QOL one year after surgery was significantly associated with greater mood disturbance and body image discomfort one month after surgery, as well as positive lymph node involvement. Although the majority of patients experienced substantial disruptions in the physical and psychosocial dimensions of QOL post-operatively, most women recovered during the year after surgery, with only a minority (<10%) significantly worsening during that time. Conclusions. At one year after surgery, most women report high levels of functioning and QOL, with no relationship between the type of surgery and QOL. Women who reported lower levels of QOL at one year after diagnosis had greater mood disturbance and poorer body image one month after surgery, as well as lower income and positive axillary nodes. Introduction Breast cancer is the most common neoplasm in North American and European women today. Although mor- tality rates from breast cancer are declining [1, 2], many women will survive the disease and experience physical and psychological sequelae that affect their everyday lives [3]. Few prospective studies have ex- amined the rehabilitation needs of newly diagnosed breast cancer patients and little is known about the predictors of health-related quality of life (QOL) in this population. As medical resources have become scarcer, describing the effects of the breast cancer and its treatments on the QOL of patients is increasingly