Background

Breast cancer and mastectomy can substantially affect psychological well-being and quality of life. Psychological distress may arise from cancer-related uncertainty, treatment burden, body-image changes, pain, and disruption of social and family roles. However, the relationship between psychological distress and multidimensional quality of life among women after mastectomy remains insufficiently characterized in Indian clinical settings.

Methods

A hospital-based cross-sectional descriptive correlational study was conducted among 99 women who had undergone mastectomy for breast cancer. Sociodemographic and clinical information was collected using a structured schedule. Psychological distress was assessed using the 21-item Depression Anxiety Stress Scale (DASS-21), and quality of life was assessed using the WHOQOL-BREF. Pearson/Spearman correlation and multivariable linear regression were used to examine associations, with p<0.05 considered statistically significant.

Results

The mean age was 49.7±10.4 years. Moderate-to-extremely severe depression, anxiety, and stress were present in 41.4%, 48.5%, and 27.3%, respectively. The mean composite WHOQOL-BREF score was 60.8±13.2, with psychological health scoring lowest (56.7±15.9). Overall distress burden correlated negatively with physical (r=−0.52), psychological (r=−0.67), social (r=−0.39), environmental (r=−0.28), and composite QoL (r=−0.61; all p≤0.005). After adjustment, distress remained independently associated with poorer QoL (adjusted β=−0.43, p<0.001). Moderate/severe pain (p=0.007), stage III disease (p=0.038), and low/moderate family support (p=0.010) were additional independent predictors. The model explained 56% of adjusted QoL variance.

Conclusion

Psychological distress was common and strongly associated with poorer quality of life among women following mastectomy. Routine psychological screening, effective symptom control, and family-centred psychosocial support should form part of comprehensive post-mastectomy care.