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Changes in quality of life among breast cancer patients three years post-diagnosis

  • Epidemiology
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Abstract

Objectives To evaluate changes in quality of life (QOL) and identify medical and socio-demographic predictors of QOL among breast cancer survivors 3 years after diagnosis. Methods Between April 2002 and March 2004 2,232 women with breast cancer were recruited into the Shanghai Breast Cancer Survival Study, a population-based cohort study, approximately 6 months after cancer diagnosis. QOL was evaluated at 6 and 36 months post-diagnosis using the General Quality of Life Inventory. Multiple linear regression models were used to evaluate changes in QOL and their associations with socio-demographic and medical factors. Results In general, breast cancer patients showed significant improvement over time in the physical, psychological, and social well-being domains, as well as overall QOL. However, QOL scores in several facets did not improve or even deteriorated, including increased negative feelings, reduced social support and interpersonal relationships, and worsened financial situation and living environment. Age at diagnosis was inversely associated with QOL changes in physical and psychological well-being and overall QOL scores. Compared with those who were disease-free, patients with a recurrence of disease had significantly poorer QOL scores across all well-being domains and almost all facets. Patients who received radiotherapy experienced significant improvements in physical and social well-being and overall QOL. Mixed ER/PR status was associated with improved scores in physical and psychological well-being and overall QOL. Education, body mass index, Charlson comorbidity score, TNM stage, type of surgery, chemotherapy, and immunotherapy were only associated with changes in certain well-being domains and/or facets, but not overall QOL. Tamoxifen use was not associated with changes in QOL outcomes. Conclusions Our study provides valuable information for developing strategies/interventions for improving the QOL of breast cancer patients.

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Acknowledgements

This study was supported by a Department of Defense Breast Cancer Research Program grant (DAMD17-02-1-0607, PI: Dr Xiao-Ou Shu). The United States 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 in part by the National Institutes of Health grants: 2 U54 CA091408 and P20 RR011792. 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 for her assistance in manuscript preparation.

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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, Vanderbilt Epidemiology Center, Vanderbilt University Medical Center, 2525 West End Avenue, Suite 600, Nashville, TN, 37203-1738, USA

    Yong Cui, Xiaoli Chen, Hui Cai, 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., Chen, X. et al. Changes in quality of life among breast cancer patients three years post-diagnosis. Breast Cancer Res Treat 114, 357–369 (2009). https://doi.org/10.1007/s10549-008-0008-3

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