Changes in Life Satisfaction and Self-Esteem During Neoadjuvant Chemotherapy in Women with Breast Cancer: A Prospective Observational Study

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Background/Objectives: Neoadjuvant chemotherapy is widely used in the treatment of breast cancer and improves oncological outcomes; however, its impact on patients’ psychosocial well-being remains insufficiently explored. This study aimed to assess changes in life satisfaction and self-esteem in women with breast cancer undergoing neoadjuvant chemotherapy. Methods: A prospective observational study was conducted among 211 women diagnosed with breast cancer and treated with neoadjuvant chemotherapy. Life satisfaction was assessed using the Satisfaction with Life Scale, and self-esteem was measured with the Rosenberg Self-Esteem Scale. Assessments were performed one week before initiation of chemotherapy and three weeks after its completion. Statistical analyses included descriptive statistics, the Wilcoxon signed-rank test, and Spearman correlation analysis. Results: A significant decrease in life satisfaction was observed after chemotherapy (mean 21.6 vs. 18.7; p < 0.001), indicating a shift from slight satisfaction to slight dissatisfaction. Self-esteem also significantly decreased (29.4 vs. 27.8; p < 0.001), although it remained within the average range. A decline in life satisfaction was reported in 60.7% of patients and a decrease in self-esteem in 50.2%. A significant positive correlation between life satisfaction and self-esteem was observed both before and after treatment. Financial status significantly differentiated both outcomes after chemotherapy. Conclusions: Neoadjuvant chemotherapy is associated with a significant decline in life satisfaction and self-esteem in women with breast cancer, highlighting its psychosocial impact. These findings support the need for routine assessment of psychological well-being and the integration of psycho-oncological support into comprehensive cancer care. Because the post-treatment assessment was performed shortly after chemotherapy completion, the findings primarily reflect short-term changes during treatment phase.

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