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Pre-Existing Diabetes in Early Stage Breast Cancer Patients is Associated with Lack of Improvement in Quality of Life 2 Years After Diagnosis

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Abstract

Purpose

Type 2 diabetes is a common comorbidity among breast cancer survivors. Our aim was to assess the association between diabetes and quality of life (QOL) in newly diagnosed early stage (0-IIA) breast cancer patients over a 2-year follow-up.

Methods

We used data from a longitudinal study of 549 breast cancer patients, aged ≥40 years. During four telephone interviews administered 4–6 weeks and 6, 12, and 24 months after definitive surgical treatment, we measured QOL using the Functional Assessment of Cancer Therapy-Breast (FACT-B) scale; higher scores indicate better QOL. Repeated measures analysis of variance was used to test the change over time in total FACT-B and each of the five subscales (physical, social, emotional and functional well-being, and breast cancer concerns), comparing patients with and without diabetes at baseline.

Results

After adjusting for covariates (age, race, body mass index, education, marital status, cancer staging, and surgical side effects), patients with (vs. without) diabetes reported lower QOL over time on the total FACT-B (least-squares mean [standard error] 106.2 [2.1] vs. 112.0 [1.1]; p = 0.0038) and on physical, social, emotional, and functional well-being subscales (each p < 0.05). Over the 2-year follow-up, QOL improved significantly for the emotional well-being (p < 0.0001) and breast cancer concern subscales (p = 0.0282) among patients without diabetes, but not among patients with diabetes.

Conclusion

Early stage breast cancer patients with diabetes may need additional care considerations to improve QOL.

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Acknowledgments

The authors thank the study participants, interviewers, the Siteman Cancer Center’s Health Behavior, Communication and Outreach Core for data management, and the many physicians and nurses who helped us recruit their patients for this study at Washington University School of Medicine and at Saint Louis University School of Medicine.

Grant support: The National Cancer Institute and Breast Cancer Stamp Fund (R01 CA102777; PI: D.B. Jeffe) and the National Cancer Institute Cancer Center Support Grant (P30 CA91842; PI: T. Eberlein) to the Alvin J. Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine in St. Louis, Missouri.

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Authors and Affiliations

  1. Department of Family and Consumer Sciences, University of Tennessee, Knoxville, TN, 37996, USA

    Soghra Jarvandi

  2. Department of Internal Medicine, Washington University School of Medicine, Saint Louis, MO, 63110, USA

    Maria Pérez & Donna B. Jeffe

  3. College for Public Health and Social Justice, Saint Louis University, Saint Louis, MO, 63104, USA

    Mario Schootman

  4. Alvin J. Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine, Saint Louis, MO, 63110, USA

    Mario Schootman & Donna B. Jeffe

Authors
  1. Soghra Jarvandi
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  2. Maria Pérez
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  4. Donna B. Jeffe
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Corresponding author

Correspondence to Soghra Jarvandi.

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Funding

This study was funded by the National Cancer Institute and Breast Cancer Stamp Fund (R01 CA102777; PI: D.B. Jeffe) and supported in part by the National Cancer Institute Cancer Center Support Grant (P30 CA91842; PI: T. Eberlein) to the Alvin J. Siteman Cancer Center at Barnes-Jewish Hospital, and Washington University School of Medicine in St. Louis, Missouri.

Conflict of Interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

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

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Jarvandi, S., Pérez, M., Schootman, M. et al. Pre-Existing Diabetes in Early Stage Breast Cancer Patients is Associated with Lack of Improvement in Quality of Life 2 Years After Diagnosis. Int.J. Behav. Med. 23, 722–729 (2016). https://doi.org/10.1007/s12529-016-9577-4

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  • DOI: https://doi.org/10.1007/s12529-016-9577-4

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