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Impact of newly diagnosed breast cancer on quality of life among Chinese women

  • Epidemiology
  • Published:
Breast Cancer Research and Treatment Aims and scope Submit manuscript

Abstract

Background

Being diagnosed with breast cancer is a very stressful event that has a profound impact on multiple aspects of a patient’s daily life. Little is known about the quality of life (QOL) of Chinese women with newly diagnosed breast cancer.

Methods

The authors evaluated QOL in 2,236 Chinese women with newly diagnosed breast cancer who were recruited into the Shanghai Breast Cancer Survival Study between April 1, 2002 and March 31, 2004. Patients’ QOL was assessed after cancer diagnosis (median time 6.4 months; range 3.6–11.1 months) by using the General Quality of Life Inventory. Multiple linear regression models were used to analyze the associations of QOL outcomes with medical and socio-demographic factors.

Results

Patients showed significantly worse overall QOL and perceived health status than healthy women, reflected mainly by lower QOL scores in physical and psychological well-being domains. Completion of radiotherapy, ever use of tamoxifen, being underweight, having an increased number of chronic diseases, and low household income were significantly associated with lower overall QOL scores after adjusting for other factors. Age at diagnosis was inversely associated with physical well-being, positively associated with material well-being, and had minimal influence on overall QOL. Stage of disease, chemotherapy, and education were only associated with certain domains, but had no influence on overall QOL. Estrogen receptor/progesterone receptor status and type of surgery or immunotherapy did not appear to be associated with QOL.

Conclusions

The findings of the present study provide important information on QOL and their correlates among Chinese women with newly diagnosed breast cancer and are helpful in developing treatment strategies accordingly.

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References

  1. Parkin DM, Bray F, Ferlay J, Pisani P (2005) Global cancer statistics, 2002. CA Cancer J Clin 55:74–108

    Article  PubMed  Google Scholar 

  2. Jin F, Devesa SS, Chow WH, Zheng W, Ji BT, Fraumeni JF Jr, Gao YT (1999) Cancer incidence trends in urban Shanghai, 1972–1994: an update. Int J Cancer 83:435–440

    Article  PubMed  CAS  Google Scholar 

  3. Yang L, Parkin DM, Ferlay J, Li L, Chen Y (2005) Estimates of cancer incidence in China for 2000 and projections for 2005. Cancer Epidemiol Biomarkers Prev 14:243–250

    Article  PubMed  Google Scholar 

  4. Fallowfield L (2002) Quality of life: a new perspective for cancer patients. Nat Rev Cancer 2:873–879

    Article  PubMed  CAS  Google Scholar 

  5. Sprangers MAG (2002) Quality-of-life assessment in oncology: achievements and challenges. Acta Oncol 42:229–237

    Article  Google Scholar 

  6. Aaronson NK, Ahmedzai S, Bergman B, Bullinger M, Cull A, Duez NJ, Filiberti A, Flechtner H, Fleishman SB, de Haes JC, Kaasa S, Klee M, Osoba D, Razavi D, Rofe RB, Schraub S, Sneeuw K, Sullivan M, Takeda F (1993) The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst 85:365–376

    Article  PubMed  CAS  Google Scholar 

  7. Bloom JR (2002) Surviving and thriving. Psychooncology 11:89–92

    Article  PubMed  Google Scholar 

  8. American Society of Clinical Oncology Outcomes Working Group (1996) Outcomes of cancer treatment for technology assessment and cancer treatment guidelines. J Clin Oncol 14: 671–679

    Google Scholar 

  9. Movsas B (2003) Quality of life in oncology trials: a clinical guide. Semin Radiat Oncol 13:235–247

    Article  PubMed  Google Scholar 

  10. Fallowfield L (2005) Acceptance of adjuvant therapy and quality of life issues. Breast 14:612–616

    Article  PubMed  Google Scholar 

  11. Bland KI (1997) Quality-of-life management for cancer patients. CA Cancer J Clin 47:194–197

    PubMed  CAS  Google Scholar 

  12. Marshall PA (1990) Cultural influences on perceived quality of life. Semin Oncol Nurs 6:278–284

    Article  PubMed  CAS  Google Scholar 

  13. Bernhard J, Hurny C, Coates AS, Peterson HF, Castiglione-Gertsch M, Gelber RD, Galligioni E, Marini G, Thurlimann B, Forbes JF, Goldhirsch A, Senn HJ, Rudenstam CM (1998) Factors affecting baseline quality of life in two international adjuvant breast cancer trials. International Breast Cancer Study Group (IBCSG). Br J Cancer 78:686–693

    PubMed  CAS  Google Scholar 

  14. Cui Y, Shu XO, Gao Y, Cai H, Wen W, Ruan ZX, Jin F, Zheng W (2004) The long-term impact of medical and socio-demographic factors on the quality of life of breast cancer survivors among Chinese women. Breast Cancer Res Treat 87:135–147

    Article  PubMed  Google Scholar 

  15. Li L, Wei H, Young D (1995) The development of the General Quality of life Inventory. China Ment Health J 9:227–231

    Google Scholar 

  16. Li L, Young D, Wei H, Zhang Y, Zheng Y, Xiao S, Wang X, Chen X (1998) The relationship between objective life status and subjective life satisfaction with quality of life. Behav Med 23:149–159

    Article  PubMed  CAS  Google Scholar 

  17. Janz NK, Mujahid M, Lantz PM, Fagerlin A, Salem B, Morrow M, Deapen D, Katz SJ (2005) Population-based study of the relationship of treatment and sociodemographics on quality of life for early stage breast cancer. Qual Life Res 14:1467–1479

    Article  PubMed  Google Scholar 

  18. Dorval M, Maunsell E, Deschenes L, Brisson J, Masse B (1998) Long-term quality of life after breast cancer: comparison of 8-year survivors with population controls. J Clin Oncol 16:487–494

    PubMed  CAS  Google Scholar 

  19. Okano Y, Okamura H, Watanabe T, Narabayashi M, Katsumata N, Ando M, Adachi I, Kazuma K, Akechi T, Uchitomi Y (2001) Mental adjustment to first recurrence and correlated factors in patients with breast cancer. Breast Cancer Res Treat 67:255–262

    Article  PubMed  CAS  Google Scholar 

  20. Bull AA, Meyerowitz BE, Hart S, Mosconi P, Apolone G, Liberati A (1999) Quality of life in women with recurrent breast cancer. Breast Cancer Res Treat 54:47–57

    Article  PubMed  CAS  Google Scholar 

  21. Frost MH, Suman VJ, Rummans TA, Dose AM, Taylor M, Novotny P, Johnson R, Evans RE (2000) Physical, psychological and social well-being of women with breast cancer: the influence of disease phase. Psychooncology 9:221–231

    Article  Google Scholar 

  22. Oh S, Heflin L, Meyerowitz BE, Desmond KA, Rowland JH, Ganz PA (2004) Quality of life of breast cancer survivors after a recurrence: a follow-up study. Breast Cancer Res Treat 87:45–57

    Article  PubMed  Google Scholar 

  23. Northouse LL, Mood D, Kershaw T, Schafenacker A, Mellon S, Walker J, Galvin, Decker V (2002) Quality of life of women with recurrent breast cancer and their family members. J Clin Oncol 20:4050–4064

    Article  PubMed  Google Scholar 

  24. Fisher B, Anderson S, Bryant J, Margolese RG, Deutsch M, Fisher ER, Jeong JH, Wolmark N (2002) Twenty-year follow-up of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer. N Engl J Med 347:1233–1241

    Article  PubMed  Google Scholar 

  25. Veronesi U, Cascinelli N, Mariani L, Greco M, Saccozzi R, Luini A, Aguilar M, Marubini E (2002) Twenty-year follow-up of a randomized study comparing breast-conserving surgery with radical mastectomy for early breast cancer. N Engl J Med 347:1227–1232

    Article  PubMed  Google Scholar 

  26. Poggi MM, Danforth DN, Sciuto LC, Smith SL, Steinberg SM, Liewehr DJ, Menard C, Lippman ME, Lichter AS, Altemus RM (2003) Eighteen-year results in the treatment of early breast carcinoma with mastectomy versus breast conservation therapy: the National Cancer Institute Randomized Trial. Cancer 98:697–702

    Article  PubMed  Google Scholar 

  27. Nissen MJ, Swenson KK, Ritz LJ, Farrell JB, Sladek ML, Lally (2001) Quality of life after breast carcinoma surgery: a comparison of three surgical procedures. Cancer 91:1238–1246

    Article  PubMed  CAS  Google Scholar 

  28. Ganz PA, Schag AC, Lee JJ, Polinsky ML, Tan SJ (1992) Breast conservation versus mastectomy. Is there a difference in psychological adjustment or quality of life in the year after surgery? Cancer 69:1729–1738

    Article  PubMed  CAS  Google Scholar 

  29. Janni W, Rjosk D, Dimpfl TH, Haertl K, Strobl B, Hepp F, Hanke A, Bergauer F, Sommer H (2001) Quality of life influenced by primary surgical treatment for stage I–III breast cancer-long-term follow-up of a matched-pair analysis. Ann Surg Oncol 8:542–548

    PubMed  CAS  Google Scholar 

  30. Rowland JH, Desmond KA, Meyerowitz BE, Belin TR, Wyatt GE, Ganz PA (2000) Role of breast reconstructive surgery in physical and emotional outcomes among breast cancer survivors. J Natl Cancer Inst 92:1422–1429

    Article  PubMed  CAS  Google Scholar 

  31. Kagawa-Singer M, Wellisch DK, Durvasula R (1997) Impact of breast cancer on Asian American and Anglo American women. Cult Med Psychiatry 21:449–480

    Article  PubMed  CAS  Google Scholar 

  32. Eifel P, Axelson JA, Costa J, Crowley J, Curran WJ Jr, Deshler A, Fulton S, Hendricks CB, Kemeny M, Kornblith AB, Louis TA, Markman M, Mayer R, Roter D (2001) National Institutes of Health Consensus Development Conference Statement: adjuvant therapy for breast cancer, November 1–3, 2000. J Natl Cancer Inst 93:979–989

    Article  PubMed  CAS  Google Scholar 

  33. Hickok JT, Morrow GR, Roscoe JA, Mustian K, Okunieff P (2005) Occurrence, severity, and longitudinal course of twelve common symptoms in 1129 consecutive patients during radiotherapy for cancer. J Pain Symptom Manage 30:433–442

    Article  PubMed  Google Scholar 

  34. Whelan TJ, Levine M, Julian J, Kirkbride P, Skingley P (2000) The effects of radiation therapy on quality of life of women with breast carcinoma: results of a randomized trial. Ontario Clinical Oncology Group. Cancer 88:2260–2266

    Article  PubMed  CAS  Google Scholar 

  35. Whelan TJ, Pritchard KI (2006) Managing patients on endocrine therapy: focus on quality-of-life issues. Clin Cancer Res 12:1056s–1060s

    Article  PubMed  CAS  Google Scholar 

  36. Day R, Ganz PA, Costantino JP, Cronin WM, Wickerham DL, Fisher B (1999) Health-related quality of life and tamoxifen in breast cancer prevention: a report from the National Surgical Adjuvant Breast and Bowel Project P-1 study. J Clin Oncol 17:2659–2669

    PubMed  CAS  Google Scholar 

  37. Love RR, Cameron L, Connell B (1991) Symptoms associated with tamoxifen treatment in postmenopausal women. Arch Intern Med 151:1842–1847

    Article  PubMed  CAS  Google Scholar 

  38. Fallowfield L, Cella D, Cuzick J, Francis S, Locker G, Howell A (2004) Quality of life of postmenopausal women in the Arimidex, Tamoxifen, Alone or in Combination (ATAC) Adjuvant Breast Cancer Trial. J Clin Oncol 22:4261–4271

    Article  PubMed  CAS  Google Scholar 

  39. Ayres A, Hoon PW, Franzoni JB, Matheny KB, Cotanch PH, Takayanagi S (1994) Influence of mood and adjustment to cancer on compliance with chemotherapy among breast cancer patients. J Psychosom Res 38:393–402

    Article  PubMed  CAS  Google Scholar 

  40. Colleoni M, Mandala M, Peruzzotti G, Robertson C, Bredart A, Goldhirsch A (2000) Depression and degree of acceptance of adjuvant cytotoxic drugs. Lancet 356:1326–1327

    Article  PubMed  CAS  Google Scholar 

  41. Simmons K, Lindsay S (2001) Psychological influences on acceptance of postsurgical treatment in cancer patients. J␣Psychosom Res 51:355–360

    Article  PubMed  CAS  Google Scholar 

  42. Carmichael AR, Bates T (2004) Obesity and breast cancer: a review of the literature. Breast 13:85–92

    Article  PubMed  CAS  Google Scholar 

  43. Whiteman MK, Hillis SD, Curtis KM, McDonald JA, Wingo PA, Marchbanks PA (2005) Body mass and mortality after breast cancer diagnosis. Cancer Epidemiol Biomarkers Prev 14:2009–2014

    Article  PubMed  Google Scholar 

  44. Huang IC, Frangakis C, Wu AW (2006) The relationship of excess body weight and health-related quality of life: evidence from a population study in Taiwan. Int J Obes (Lond) [Epub ahead of print]

  45. Doll HA, Petersen SE, Stewart-Brown SL (2000) Obesity and physical and emotional well-being: associations between body mass index, chronic illness, and the physical and mental components of the SF-36 questionnaire. Obes Res 8:160–170

    Article  PubMed  CAS  Google Scholar 

  46. Ganz PA, Desmond KA, Leedham B, Rowland JH, Meyerowitz BE, Belin TR (2002) Quality of life in long-term, disease-free survivors of breast cancer: a follow-up study. J␣Natl Cancer Inst 94:39–49

    PubMed  Google Scholar 

  47. Engel J, Kerr J, Schlesinger-Raab A, Eckel R, Sauer H, Holzel D (2003) Predictors of quality of life of breast cancer patients. Acta Oncol 42:710–718

    Article  PubMed  Google Scholar 

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Acknowledgments

This study was supported by the Department of Defense Breast Cancer Program (DAMD17-02-1-0607, PI: Dr Xiao-Ou Shu). The U.S. Army Medical Research Acquisition Activity, 820 Chandler Street, Fort Detrick, MD 21702-5014, is the awarding and administering acquisition office. The content of the information does not necessarily reflect the position or the policy of the Government, and no official endorsement should be inferred. Dr Yong Cui is supported by the NIH Grants: NCMHHD 5 P20 MD000516-03 and 5 U54 CA091408. The authors thank Dr Fan Jin for her support in study implementation and the participants and staff members of the SBCSS for making this study possible. The authors also thank Ms Bethanie Hull and Ms Brandy Bentley for their assistance in manuscript preparation.

Conflict of interest: none declared.

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Authors and Affiliations

  1. Shanghai Center for Disease Control and Prevention, Shanghai, 200336, China

    Wei Lu, Ying Zheng & Kai Gu

  2. Department of Medicine, Center for Health Services Research, Vanderbilt University Medical Center, Medical Center East, Suite 6000, 1215 21st Avenue South, Nashville, TN, 37232-8300, USA

    Yong Cui, Hui Cai, Qiong Li, Wei Zheng & Xiao Ou Shu

  3. Department of Medicine, Meharry Medical College, Nashville, TN, 37208, USA

    Yong Cui

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  1. Wei Lu
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Correspondence to Xiao Ou Shu.

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Lu, W., Cui, Y., Zheng, Y. et al. Impact of newly diagnosed breast cancer on quality of life among Chinese women. Breast Cancer Res Treat 102, 201–210 (2007). https://doi.org/10.1007/s10549-006-9318-5

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  • DOI: https://doi.org/10.1007/s10549-006-9318-5

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