Background and Objectives:Surgical treatment is central to breast cancer management; however, its long-term impact on QoL varies substantially among patients. This study sought to model the dynamic trajectories of postoperative QoL following breast-conserving surgery (BCS), mastectomy with immediate reconstruction (Mx+IR), and mastectomy alone (MA). It also examined how these trajectories varied across different age groups and over time.Materials and Methods:The review and meta-analysis identified 150 peer-reviewed studies reporting QoL outcomes using validated instruments (EORTC QLQ-C30 or BREAST-Q). A total of 123 observations from 45 studies were included for analysis of global QoL. We standardized QoL scores to a 0–100 scale and harmonized postoperative assessments across six time intervals, extending to more than 73 months. Multilevel random-effects models evaluated linear, quadratic, and logarithmic functions. Subgroup analyses and meta-regressions assessed the moderating effects of surgical type and age.Results:BCS showed the steepest QoL gains, followed by Mx+IR, while MA had the lowest scores and slowest recovery. Compared to BCS, MA showed significantly poorer and delayed recovery, and Mx+IR showed a smaller, borderline decrease. All groups displayed modest long-term QoL plateauing.Conclusions:Global QoL after breast cancer surgery follows distinct, time-dependent patterns shaped by surgical approach and age. These findings emphasize the importance of discussing patients’ quality-of-life expectations with them so that survivorship care can be personalized to their needs.
**背景与目的：** 手术治疗是乳腺癌管理的核心手段，但其对患者生活质量的长期影响存在显著差异。本研究旨在构建保乳手术、乳房切除联合即刻重建术以及单纯乳房切除术后生活质量的动态变化轨迹，并探讨这些轨迹在不同年龄组及随时间推移的差异。 **材料与方法：** 通过系统综述与荟萃分析，共纳入150项使用标准化量表（EORTC QLQ-C30或BREAST-Q）报告生活质量结果的同行评议研究。其中45项研究的123项观测数据被用于整体生活质量分析。我们将生活质量评分统一转换为0-100分制，并将术后评估时间整合为六个区间（最长超过73个月）。采用多水平随机效应模型评估线性、二次函数及对数函数拟合效果，并通过亚组分析和元回归检验手术类型与年龄的调节作用。 **结果：** 保乳手术组的生活质量改善幅度最大，乳房切除联合即刻重建组次之，而单纯乳房切除组的评分最低且恢复最慢。与保乳手术相比，单纯乳房切除组的恢复显著延迟且程度较差，乳房切除联合即刻重建组仅出现轻微且临界的下降。所有组别在长期随访中均呈现生活质量平台期。 **结论：** 乳腺癌术后整体生活质量的变化呈现与手术方式及年龄相关的特定时间依赖性模式。这些结果强调，临床中需与患者充分沟通生活质量预期，以便根据个体需求制定个性化的生存照护方案。
肿瘤(癌症)患者之家