Age-specific detriments to quality of life among breast cancer patients one year after diagnosis

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Abstract

The aim of our study was to identify any differences in the quality of life (QOL) of breast cancer survivors one year after diagnosis when the acute treatment effects should not longer be apparent. QOL was assessed in a population-based cohort of 387 women with breast cancer from Saarland (Germany) using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC-QLC30). Functional and symptom QOL-scores were compared with published reference data from the general population. Breast cancer survivors and women from the general population reported similar scores of global health/QOL. However, major deficits among women with breast cancer were found, for emotional, social, role and cognitive functioning. Age-specific comparisons between breast cancer patients and the reference population revealed that these deficits are predominantly found in younger age groups. The overall QOL of life of breast cancer survivors one year after diagnosis is comparable to women from the general population. However, some differences exist that seem to predominantly affect younger women who show a poorer QOL in certain domains.

Introduction

Cancer of the breast is the most frequent malignant tumour among women and accounts for more than 1 000 000 new cases worldwide each year [1]. Breast cancer survivors represent the largest group of long-term cancer survivors. They comprise approximately 40% of all female cancer survivors in developed countries [2], and it can be expected that this number will increase over the next few decades due the demographic age-shift with populations living for longer and due to further advances made in breast cancer therapy.

Beside disease-free and overall survival time, quality of life (QOL) is a decisive outcome measure for cancer patients. The term QOL refers to a multidimensional concept which includes at least the dimensions physical, emotional and social functioning. QOL has become an important outcome measure in the treatment of cancer patients during the last decade and has been assessed in many clinical trials to evaluate the effects of specific therapies. In contrast, only a few studies have compared breast cancer survivors with non-cancer patients in order to identify the specific needs of these women 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15. In general, older people reported worse quality of life and worse physical functioning, but better emotional functioning, than younger people. However, the interpretation of these studies may be limited, as many of these studies were based on selective samples of patients from one or few hospitals 4, 5, 6, 7, 8, 9, 10, 11 or included women with a wide range of survival times 8, 13.

The objective of this study was to describe the QOL of patients with breast cancer one year after their diagnosis from a large population-based cohort. At this time, it could be expected that the acute treatment effects would have declined and our aim was to identify any differences in the QOL of breast cancer survivors in comparison with women from the general population.

Section snippets

Study design

This analysis is based on data obtained from the Verlauf der diagnostischen Abklärung bei Krebserkrankungen (VERDI)-study, a population-based state-wide prospective cohort study on risk factors, diagnostic procedures and prognosis for various forms of cancer in Saarland (a state in Southwest Germany covering a population of approximately 1 million inhabitants) 16, 17, 18. Potential study participants were identified by their clinicians during their first hospitalisation. With the exception of

Characteristics of the study population

Baseline characteristics of the breast cancer patients according to their vital status and follow-up are shown in Table 1. The mean age at diagnosis was 58 years (age range 30–80 years). The level of education in our study sample was relatively low. Only one quarter of all breast cancer patients completed 10 years or more of schooling in contrast to approximately 34% of reference population after correction for differences in the age distribution. However, no differences were observed between

Discussion

QOL has become an important outcome measure in the treatment of cancer patients and the specific needs of cancer survivors deserve more attention. Our results suggest that overall QOL/global health and physical functioning of breast cancer patients is comparable to women from the general population one year after the diagnosis of breast cancer when most acute treatment-related effects should have disappeared. In contrast, deficits in emotional, social, role, and cognitive functioning are still

Conflict of interest statement

There is no conflict of interest for any author of this study. There are no financial or other relationships that might bias the work or interfere with our objective judgement(s).

Acknowledgements

This study was supported by the German Cancer Foundation (Deutsche Krebshilfe), Project Number 70-2413-Br 3 I.

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    VA and HM contributed equally to the manuscript.

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