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Health-related quality of life in long-term disease-free breast cancer survivors versus female population controls in Germany

  • Epidemiology
  • Published:
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Abstract

Purpose

Little is known about breast cancer (BC) survivors’ health-related quality of life (HRQoL) > 5 or even > 10 years past diagnosis. It is of interest whether, in the long run, survivors’ HRQoL aligns with that of the general population. Study objectives were to (1) compare disease-free BC survivors’ HRQoL to that of non-cancer controls, and (2) compare long-term survivors (LTS, 5–9 years post-diagnosis), very long-term survivors (VLTS, ≥ 10 years post-diagnosis), and controls with respect to their HRQoL.

Methods

The samples of 2647 disease-free BC survivors (5–16 years post-diagnosis) and 1005 population controls were recruited in German multi-regional population-based studies. HRQoL was assessed by the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire—Core 30 (EORTC QLQ-C30). Differences in HRQoL were assessed with multiple regression, controlling for age and education.

Results

Disease-free BC survivors < 80 years (at survey) reported overall global health status/quality of life comparable to controls, but statistically significant lower physical, role, emotional, social, and cognitive functioning. They also indicated more fatigue, insomnia, dyspnoea, and financial difficulties. However, differences were only of trivial or small clinical relevance. At age 80–89, no differences between BC survivors and controls were observed. Deficits in emotional and cognitive functioning and some symptoms (e.g. insomnia and fatigue) persist, as both LTS and VLTS reported more detriments than controls.

Conclusions

In view of the persistent, small but significant detriments in disease-free BC survivors’ cognitive and emotional functioning and higher symptom burden, possibilities to prevent detriments from becoming chronic should be explored.

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Funding

This work was supported by two grants from the German Cancer Aid (Nos. 108262 and 110231).

Author information

Authors and Affiliations

  1. Unit of Cancer Survivorship, Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany

    Daniela Doege, Melissa Suk-Yin Thong & Volker Arndt

  2. Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany

    Lena Koch-Gallenkamp, Lina Jansen & Hermann Brenner

  3. Cancer Registry of North Rhine-Westphalia, Bochum, Germany

    Heike Bertram

  4. Bremen Cancer Registry, Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany

    Andrea Eberle

  5. Saarland Cancer Registry, Saarbrücken, Germany

    Bernd Holleczek

  6. Cancer Registry of Schleswig-Holstein, Lübeck, Germany

    Ron Pritzkuleit

  7. Hamburg Cancer Registry, Ministry of Health and Consumer Protection, Hamburg, Germany

    Mechthild Waldeyer-Sauerland & Annika Waldmann

  8. Institute of Social Medicine and Epidemiology, University Lübeck, Lübeck, Germany

    Annika Waldmann

  9. Cancer Registry of Rhineland-Palatinate, Mainz, Germany

    Sylke Ruth Zeissig

  10. Division of Preventive Oncology, German Cancer Research Center (DKFZ), Heidelberg, Germany

    Hermann Brenner

  11. German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany

    Hermann Brenner

  12. German Cancer Research Center (DKFZ), Cancer Survivorship (C071), PO Box 10 19 49, 69009, Heidelberg, Germany

    Daniela Doege

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  1. Daniela Doege
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Correspondence to Daniela Doege.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures involving human participants were in accordance with the Helsinki Declaration of 1975, as revised in 1983. Both studies (CAESAR+ and LINDE) were approved by the ethics committee of the medical faculty of the University of Heidelberg and by all local ethics committees accountable for the participating cancer registries.

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Written informed consent was obtained from all individual participants included in the study.

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Doege, D., Thong, M.SY., Koch-Gallenkamp, L. et al. Health-related quality of life in long-term disease-free breast cancer survivors versus female population controls in Germany. Breast Cancer Res Treat 175, 499–510 (2019). https://doi.org/10.1007/s10549-019-05188-x

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