Skip to main content
Log in

Quality of Life of Breast Cancer Survivors After a Recurrence: A Follow-Up Study

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

Abstract

Previous studies on breast cancer recurrence provide a mixed picture of the quality of life of women following a recurrence. To clarify the picture, the present study addresses some previous methodological concerns by offering a multidimensional assessment with follow-up, a matched comparison group of disease-free survivors, and a closer look at the nature of recurrence (local versus metastatic). Fifty-Four of 817 women who participated in an earlier study experienced a recurrence at follow-up, and are compared to a matched sample of 54 women who remained disease-free. Analyses indicate that women who had a recurrence report significantly poorer functioning on various health-related quality of life (HRQOL) domains compared to women who remained disease-free. However, the differences appear to be largely due to the poorer HRQOL of women with metastatic disease. Although women who had a recurrence report good mood, low stress, and good quality of interpersonal relationships, they report significantly higher cancer-specific stress compared to disease-free women at follow-up. Women who had a recurrence also report experiencing both more meaning and vulnerability as a result of breast cancer than disease-free women, but report similar levels of spirituality and benefit-finding at follow-up as disease-free women. These results suggest that although women report relatively good psychosocial adjustment following a recurrence, cancer-specific domains of quality of life are most likely to be negatively affected. These results may be useful in identifying individuals with breast cancer recurrences who are most in need of psychosocial services.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Silverfarb PM, Maurer LH, Crouthamel CS: Psychosocial aspects of neoplastic disease: I. Functional status of breast cancer patients during different treatment regimens. Am J Psychiatry 137: 450–455, 1980

    PubMed  Google Scholar 

  2. Northouse LL, Laten D, Reddy P: Adjustment of women and their husbands to recurrent breast cancer. Res Nurs Health 18: 515–524, 1995

    PubMed  Google Scholar 

  3. McEnvoy MD, McCorkle R: Quality of life issues in patients with disseminated breast cancer. Cancer 66 (6 Suppl.): 1416–1421, 1990

    PubMed  Google Scholar 

  4. Mahon SM, Cella DF, Donovan MI: Psychosocial adjustment to recurrent cancer. Oncol Nurs Forum 17: 47–52, 1990

    PubMed  Google Scholar 

  5. Ballard A, Green T, McCaa A, Logsdon MC: A comparison of the level of hope in patients with newly diagnosed and recurrent cancer. Oncol Nurs Forum 24: 899–904, 1997

    PubMed  Google Scholar 

  6. Weisman AD, Worden JW: The emotional impact of recurrent cancer. J Psychosoc Oncol 3: 5–16, 1986

    Google Scholar 

  7. Given B, Given CW: Patient and family caregiver reaction to new and recurrent breast cancer. J Am Med Womens Assoc 47: 201–206, 212, 1992

    PubMed  Google Scholar 

  8. Munkres A, Oberst MT, Hughes SH: Appraisal of illness, symptom distress, self-care burden, and mood states in patients receiving chemotherapy for initial and recurrent cancer. Oncol Nurs Forum 19: 1201–1209, 1992

    PubMed  Google Scholar 

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

    Article  PubMed  Google Scholar 

  10. Le MG, Arriagada R, Spielmann M, Guinebretiere JM, Rochard F: Prognostic factors for death after an isolated local recurrence in patients with early stage breast carcinoma. Cancer 94: 2813–2820, 2000

    Article  Google Scholar 

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

    Article  PubMed  Google Scholar 

  12. Hurney C, Bernhard J, Coates AS, Castiglione-Gertsch M, Peterson HF, Gelber RD, Forbes JF, Rudenstam C-M, Simoncini E, Crivellari D, Goldhirsch A, Senn H-J, for the International Breast Cancer Study Group: impact of adjuvant therapy on quality of life in women with node-positive breast cancer. Lancet 347: 1279–1284, 1996

    PubMed  Google Scholar 

  13. Jenkins PL, May VE, Hughes LE: Psychological morbidity associated with local recurrence of breast cancer. Int J Psychiatry Med 21: 149–155, 1991

    PubMed  Google Scholar 

  14. Okamura H, Watanabe T, Narabayashi M, Katsumata N, Ando M, Adachi I, Akechi T, Uchitomi Y: Psychological distress following rst recurrence of diseasein patients with breast cancer: prevalence and risk factors. Breast Cancer Res Treat 61: 131–137, 2000

    Article  PubMed  Google Scholar 

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

    Article  PubMed  Google Scholar 

  16. Lewis FM, Deal LW: Balancing our lives: a study of the married couple 's experience with breast cancer recurrence. Oncol Nurs Forum 22: 943–953, 1995

    PubMed  Google Scholar 

  17. Taylor EJ: Factors associated with meaning in life among people with recurrent cancer. Oncol Nurs Forum 20: 1399–1405, 1993

    PubMed  Google Scholar 

  18. Ganz PA, Desmond KA, Leedham B, Rowland JH, Meyerowitz BE, Belin TR: Quality of life in long-term, disease-free survivors of breast cancer: a follow-up study. J Natl Cancer Inst 1: 39–49, 1994

    Google Scholar 

  19. Ganz PA, Rowland JH, Desmond K, Meyerowitz BE, Wyatt GE: Life after breast cancer: understanding women 's health-related quality of life and sexual functioning. J Clin Oncol 16: 501–514, 1998

    PubMed  Google Scholar 

  20. Ganz PA, Rowland JH, Meyerowitz BE, Desmond KA: Impact of different adjuvant therapy strategies on quality of life in breast cancer survivors. Recent Results Cancer Res 152: 396–411, 1998

    PubMed  Google Scholar 

  21. Ware JE Jr, Sherbourne CD: The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care 30: 473–483, 1992

    PubMed  Google Scholar 

  22. Hays RD, Sherbourne CD, Mazel RM: The RAND 36-item Health Survey1. 0. Health Econ 2: 217–227, 1993

    PubMed  Google Scholar 

  23. McHorney CA, Kosinski M, Ware JE Jr: Comparisons of the costs and quality of norms for the SF-36 health survey collected by mail versus telephone interview: results from a national survey. Med Care 32: 551–567, 1994

    PubMed  Google Scholar 

  24. Ware JE Jr, Kosinki M, Keller SD: SF-36 Physical and Mental Health Summary Scales: A User 's Manual. The Health Institute, Boston, MA, 1994

    Google Scholar 

  25. RadloffLS: The CES-D Scale: a self-report depression scale for research in the general population. Appl Psychol Measure 1: 385–401, 1977

    Google Scholar 

  26. Roberts RE, Vernon SW: The Center for Epidemiological Studies Depression Scale: its use in a community sample. Am J Psychiatry 140: 41–46, 1983

    PubMed  Google Scholar 

  27. Myers JK, Weissman MM: Use of a self-report symptom scale to detect depression in a community sample. Am J Psychiatry 137: 1081–1084, 1980

    PubMed  Google Scholar 

  28. Watson D, Clark LA, Tellegen A: Development and validation of brief measures of positive and negative affect: the PANAS scales. J Pers Soc Psychol 54: 1063–1070, 1988

    Article  PubMed  Google Scholar 

  29. Weiss DS, Marmar CR: The impact of event scale-revised. In: Wilson JP, Keane TM (eds) Assessing Psychological Trauma. Guilford Press, New York, 1997, pp 399–411

    Google Scholar 

  30. Busby DM, Christensen C, Crane DR, Larson JH: A revision of the dyadic adjustment scale for use with distressed and nondistressed couples: construct hierarchy and multidimensional scales. J Marital Fam Ther 21: 289–308, 1995

    Google Scholar 

  31. Spanier GB: Measuring dyadic adjustment: new scales for assessing the quality of marriage and similar dyads. J Marriage Family 38: 15–28, 1976

    Google Scholar 

  32. Sherbourne CD, Stewart AL: The MOS Social Support Survey. Soc Sci Med 32: 705–714, 1991

    Article  PubMed  Google Scholar 

  33. Tedeschi RG, Calhoun LG: The post-traumatic growth inventory. J Trauma Stress 9: 455–472, 1996

    Article  PubMed  Google Scholar 

  34. Holland J, Kash KM, Passik S, Gronert MK, Sison A, Lederberg M, Russak SM, Baider L, Fox B: A brief spiritual beliefs inventory for use in quality of life research in lifethreatening illnesses. Psychooncology 7: 460–469, 1998

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Oh, S., Heflin, L., Meyerowitz, B.E. et al. Quality of Life of Breast Cancer Survivors After a Recurrence: A Follow-Up Study. Breast Cancer Res Treat 87, 45–57 (2004). https://doi.org/10.1023/B:BREA.0000041580.55817.5a

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1023/B:BREA.0000041580.55817.5a

Navigation