Purpose: To investigate the quality of life and satisfaction after different operations in patients with breast cancer, which are breast conserving therapy (BCT), mastectomy and reconstruction after breast BCT or mastectomy.

Materials and methods: 180 patients with breast cancer who were operated from January 2005 to October 2006 were chosen. They presented without local or distant metastasis in this period of time and were asked to complete the EORTC quality of life questionnaire (QLQ-C30), the EORTC breast cancer module questionnaire (QLQ-BR23) and a specific questionnaire regarding satisfaction of postoperative results designed by ourselves.

Results: Of 112 (62.2%) patients who responded there were 76, 20 and 16 patients in the group of BCT, mastectomy and reconstruction, respectively. Compared with the mastectomy group and reconstruction group, the patients in BCT group had better body image (BI) (P = 0.004, P = 0.003), the patients in the group of reconstruction had more financial difficulties (FD) and more future perspective (FP) than the BCT group (P = 0.006, P = 0.039). Compared with the group of mastectomy and reconstruction, the patients in the group of BCT had a better self-assessment of postoperative results (P = 0.001, P < 0.001) and less visible postoperative scars (P = 0.003, P = 0.019). Patients in the reconstruction group thought that the difference in shape of the bilateral breast was more visible than in the BCT group (P = 0.005). Regarding visible differences in size of the breasts and satisfaction with the position and form of nipple-areolar complex, there were no differences between the two groups (P = 0.077, P = 0.272).

Conclusion: Patients with BCT have a better quality of life and higher satisfaction rate with their postoperative breasts compared to patients undergoing mastectomy or reconstructive surgery.