Health-Related Quality of Life: Longitudinal Analysis From the Time of Breast Biopsy Into the Post-treatment Period

Background: The physical, psychological, social, and spiritual quality of life (QoL) may be affected by breast cancer diagnosis and treatment, with mixed findings for psychological quality of life and cognitive ability performance. The present study aimed to evaluate QoL in women over 1 year from biopsy for a breast abnormality.Methods: Self-reported measures of physical, psychological, social, and spiritual QoL were obtained after biopsy results but prior to treatment initiation (baseline), 4 and 12 months later. CogState computerized neuropsychological screening battery also provided an evaluation of psychological QoL. Three groups of women including those with benign biopsy results, those with malignancy treated with chemotherapy, and those with malignancy not treated with chemotherapy were compared at 4 and 12 months after adjusting for baseline to isolate the effects of treatment. Additional covariates included are age, level of education, and income.Results: Benign biopsy results group included 72 women, whereas malignancy was found in 87 women of whom 33 were treated with chemotherapy and 54 without chemotherapy. At the time of diagnosis, women with cancer had worse psychological and social QoL but better spiritual QoL than those with benign biopsy results. Only CogState monitoring accuracy was worse for women with cancer compared with the controls at the time of biopsy results. After adjusting for QoL at baseline, women treated for cancer had worse physical and social QoL at 4 and 12 months later. Psychological well-being was worse for women with cancer at 4th month but improved at 1 year. No differences in cognition were found at 4 and 12 months when adjusted for baseline cognition and covariates.Discussion: Breast cancer is a traumatic life event for women, affecting psychological and social QoL domains, yet increasing spiritual QoL. Later, cancer treatment worsens physical, psychological, and social QoL compared with those without cancer.Conclusions: These findings suggest that interventions to improve psychological QoL may be especially important at the time of cancer diagnosis, while interventions to improve physical well-being are the most needed during and following cancer treatment. Support to improve social QoL is needed from the time of diagnosis into post-treatment survivorship.

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Quality of Life After Breast Cancer Diagnosis and Survival

Journal of Clinical Oncology ◽

10.1200/jco.2010.30.6951 ◽

2011 ◽

Vol 29 (4) ◽

pp. 406-412 ◽

Cited By ~ 82

Author(s):

Meira Epplein ◽

Ying Zheng ◽

Wei Zheng ◽

Zhi Chen ◽

Kai Gu ◽

...

Keyword(s):

Breast Cancer ◽

Quality Of Life ◽

Cancer Diagnosis ◽

Cancer Recurrence ◽

Breast Cancer Diagnosis ◽

Well Being ◽

Breast Cancer Recurrence ◽

Significant Prognostic Factor ◽

Risk Of Mortality

Purpose To examine the association of quality of life (QOL) after diagnosis of breast cancer with mortality and recurrence. Patients and Methods From 2002 to 2004, a total of 2,230 breast cancer survivors completed the General Quality of Life Inventory-74 6 months after diagnosis as part of the Shanghai Breast Cancer Survivor Study. Also collected at baseline was information on demographic and clinical characteristics. At 36 months postdiagnosis, 1,845 of these women were re-evaluated for QOL. Outcomes were ascertained by in-person interview and record linkage to the vital statistics registry. The association of QOL with total mortality and cancer recurrence was assessed by using Cox regression analysis. Results During a median follow-up of 4.8 years after the 6-month postdiagnosis QOL assessment, 284 deaths were identified. Recurrence was documented in 267 patients after 108 patients with stage IV breast cancer or recurrence before study enrollment were excluded. Women with the highest tertile of social well-being QOL score, compared with those with the lowest score, had a 38% decreased risk of mortality (95% CI, 0.46 to 0.85; P for trend = .002) and a 48% decreased risk of breast cancer recurrence (95% CI, 0.38 to 0.71; P for trend < .001). QOL assessed at 36 months postdiagnosis was not significantly associated with subsequent risk of mortality or recurrence. Conclusion Social well-being in the first year after cancer diagnosis is a significant prognostic factor for breast cancer recurrence or mortality, suggesting a possible avenue of intervention by maintaining or enhancing social support for women soon after their breast cancer diagnosis to improve disease outcomes.

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Divorce after breast cancer diagnosis and its impact on quality of life

Palliative & Supportive Care ◽

10.1017/s1478951521001711 ◽

2021 ◽

pp. 1-6

Author(s):

Danbee Kang ◽

Nayeon Kim ◽

Gayeon Han ◽

Sooyeon Kim ◽

Hoyoung Kim ◽

...

Keyword(s):

Breast Cancer ◽

Quality Of Life ◽

Cancer Survivors ◽

Cancer Diagnosis ◽

Breast Cancer Survivors ◽

Breast Cancer Diagnosis ◽

Factors Associated ◽

After Cancer ◽

The Impact

Abstract Objective This study aims to identify factors associated with divorce following breast cancer diagnosis and measures the impact of divorce on the quality of life (QoL) of patients. Methods We used cross-sectional survey data collected at breast cancer outpatient clinics in South Korea from November 2018 to April 2019. Adult breast cancer survivors who completed active treatment without any cancer recurrence at the time of the survey (N = 4,366) were included. The participants were classified into two groups: “maintaining marriage” and “being divorced,” between at the survey and at the cancer diagnosis. We performed logistic regression and linear regression to identify the factors associated with divorce after cancer diagnosis and to compare the QoL of divorced and nondivorced survivors. Results Approximately 11.1/1,000 of married breast cancer survivors experienced divorce after cancer diagnosis. Younger age, lower education, and being employed at diagnosis were associated with divorce. Being divorced survivors had significantly lower QoL (Coefficient [Coef] = −7.50; 95% CI = −13.63, −1.36), social functioning (Coef = −9.47; 95% CI = −16.36, −2.57), and body image (Coef = −8.34; 95% CI = −6.29, −0.39) than survivors who remained married. They also experienced more symptoms including pain, insomnia, financial difficulties, and distress due to hair loss. Conclusion Identifying risk factors of divorce will ultimately help ascertain the resources necessary for early intervention.

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How do recovery advice and behavioural characteristics influence upper-body function and quality of life among women 6 months after breast cancer diagnosis?

Supportive Care in Cancer ◽

10.1007/s00520-005-0838-z ◽

2005 ◽

Vol 14 (1) ◽

pp. 22-29 ◽

Cited By ~ 9

Author(s):

Tracey Round ◽

Sandra C. Hayes ◽

Beth Newman

Keyword(s):

Breast Cancer ◽

Quality Of Life ◽

Cancer Diagnosis ◽

Breast Cancer Diagnosis ◽

Upper Body ◽

Body Function ◽

Behavioural Characteristics

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Informational needs and the quality of life of patients in their first year after metastatic breast cancer diagnosis

The Journal of Community and Supportive Oncology ◽

10.12788/jcso.0077 ◽

2014 ◽

Vol 12 (10) ◽

pp. 347-354 ◽

Cited By ~ 9

Author(s):

Davinia Seah ◽

Nancy Lin ◽

Carolyn Curley ◽

Eric Winer ◽

Ann Partridge

Keyword(s):

Breast Cancer ◽

Quality Of Life ◽

Metastatic Breast Cancer ◽

Cancer Diagnosis ◽

Metastatic Breast ◽

Breast Cancer Diagnosis ◽

First Year ◽

Informational Needs

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The effect on quality of life via bio-mimetic hormone replacement therapy for breast cancer patients.

Journal of Clinical Oncology ◽

10.1200/jco.2017.35.7_suppl.113 ◽

2017 ◽

Vol 35 (7_suppl) ◽

pp. 113-113

Author(s):

TS Wiley ◽

Jason T. Haraldsen

Keyword(s):

Breast Cancer ◽

Quality Of Life ◽

Hormone Replacement Therapy ◽

Replacement Therapy ◽

Hormone Replacement ◽

Well Being ◽

Post Treatment ◽

Breast Cancer Patients ◽

Long Term Study

113 Background: Many treatments for breast cancer block the estrogen receptors to reduce the risk of relapse. However, this treatment results in massive changes to the normal hormonal milieu. When the normal rhythmic hormonal patterns are disrupted, either through treatment or normal menopause, women typically experience a multitude of harsh symptoms with little affect on relapse rate. We set out to examine and evaluate the effects of estrogen (E2) and progesterone (P4) treatments via a bio-mimetic bio-identical hormone replacement therapy (BBHRT). We theorized, through the analysis of physiological and clinical literature, that the use BBHRT in the normal physiological pattern of reproductive women will lead to an increase of overall well-being and better quality of life for post-treatment and menopausal women, but does not increase their risk of breast cancer. Methods: E2 and P4 control over 9,000 different gene products and a disruption of these processes can lead to an increase in illnesses of aging including cancer. Through an evaluation of current literature, we theorize that a BBHRT approach utilizing E2 and P4 in a bio-mimetic manner to restore a woman’s body to normal hormonal levels can be achieved through twice-daily transdermal applications of hormonal creams with peaks in serum levels on days 12 and 21. The proposed method uses compounded, bio-identical hormones dosed to mimic the female reproductive cycle. Results: While this is a proposed clinical study, it is expected that women will experience resolution of menopausal and post-treatment symptoms, including better sleep, decreased migraines and incontinence, increased focus, and increased libido. By restoring the normal hormonal rhythm, it is anticipated that the body’s natural response elements will help restore both quality of life and well being, while also protecting from possible relapse. Conclusions: We propose a method to provide better quality of life and well being for women through BHRT that combines the use of E2 and P4 in a manner that mimics a woman’s normal reproductive levels. While a small long-term study of this method has shown promising results, we conclude that further, most detailed studies are still needed.

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