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The Long-Term Impact of Medical and Socio-Demographic Factors on the Quality of Life of Breast Cancer Survivors Among Chinese Women

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Abstract

Quality of life (QOL) has become an integral part of the modern assessment of cancer treatment in Western society. However, little is known about the QOL of Chinese breast cancer survivors. To evaluate the long-term impact of medical and socio-demographic factors on survivors' QOL, we conducted a population-based study of 1065 breast cancer survivors in Shanghai, China. The mean age at diagnosis was 48.1 years and the median survival time was 4.3 years for the study participants. The Generic Quality of Life Inventory was used to assess survivors' QOL. Multiple linear regression models were employed to analyze the associations of QOL outcomes with socio-demographic and medical factors. The results revealed that recurrence status, time since diagnosis, marital status, income and education all had an independent, significant association with overall QOL and differential domains of QOL. Age at diagnosis exhibited a dual effect on QOL, positively associated with material well-being and negatively associated with physical well-being. Stage of disease was only associated with social well-being, while the type of surgery was related to material well-being alone. No associations between QOL and chemotherapy or radiotherapy were found. Further, analyses by survival intervals suggested a domain-specific order of recovery of QOL after cancer treatment. These results fill gaps in the limited literature, and provide valuable information for physicians to target the specific needs of Chinese women with breast cancer, choose appropriate interventions at the optimal time, and develop strategies accordingly in terms of improvement of patient's QOL.

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References

  1. Parkin DM:Global cancer statistics in the year 2000. Lancet Oncol 2:533–540,2001

    Google Scholar 

  2. Fallowfield L:Quality of life:a new perspective for cancer patients.Natl Rev Cancer 2:873–879,2002

    Google Scholar 

  3. Ganz PA, Coscarelli A, Fred C, Kahn B, Polinsky ML, Petersen L:Breast cancer survivors:psychosocial concerns and quality of life.Breast Cancer Res Treat 38:183–199, 1996

    Google Scholar 

  4. 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: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 85:365–376,1993

    Google Scholar 

  5. Bloom JR:Surviving and thriving.Psycho-Oncol 11:89–92, 2002

    Google Scholar 

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

    Google Scholar 

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

    Google Scholar 

  8. Gotay CC, Muraoka MY:Quality of life in long-term survivors of adult-onset cancer.J Natl Cancer Inst 90:656–667,1998

    Google Scholar 

  9. Greenlee RT, Murray T, Bolden S, Wingo PA:Cancer statistics,2000.CA Cancer J Clin 50:7–33,2000

    Google Scholar 

  10. King MT, Kenny P, Shiell A, Hall J, Boyages J:Quality of life three months and one year after rst treatment for early stage breast cancer:influence of treatment and patient characteristics.Qual Life Res 9:789–800,2000

    Google Scholar 

  11. Shimozuma K, Ganz PA, Petersen L, Hirji K:Quality of life in the rst year after breast cancer surgery:rehabilitation needs and patterns of recovery.Breast Cancer Res Treat 56:45–57,1999

    Google Scholar 

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

    Google Scholar 

  13. Mandelblatt JS, Edge SB, Meropol NJ, Senie R, Tsangaris T, Grey L, Peterson BM Jr, Hwang YT, Kerner J, Weeks J: Predictors of long-term outcomes in older breast cancer survivors:perceptions versus patterns of care.J Clin Oncol 21:855–863,2003

    Google Scholar 

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

    Google Scholar 

  15. Hartl K, Janni W, Kastner R, Sommer H, Strobl B, Rack B, Stauber M:Impact of medical and demographic factors on long-term quality of life and body image of breast cancer patients.Ann Oncol 14:1064–1071,2003

    Google Scholar 

  16. Marshall PA:Cultural influences on perceived quality of life.Semin Oncol Nurs 6:278–284,1990

    Google Scholar 

  17. 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:Factors affecting baseline quality of life in two international adjuvant breast cancer trials.International Breast Cancer Study Group (IBCSG).Br J Cancer 78:686–693,1998

    Google Scholar 

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

    Google Scholar 

  19. Jin F, Xiang YB, Gao YT:Cancer survival in Shanghai, People's Republic of China.IARC Sci Publ 145:37–50, 1998

    Google Scholar 

  20. Fung KW, Lau Y, Fielding R, Or A, Yip AW:The impact of mastectomy,breast-conserving treatment and immediate breast reconstruction on the quality of life of Chinese women.Aust NZ J Surg 71:202–206,2001

    Google Scholar 

  21. Yu CLM, Fielding R, Chan CL, Tse VK, Choi PHK, Lau WH, Choy DTK, O SK, Lee AWM, Sham JST:Measuring quality of life of Chinese cancer patients:a validation of the Chinese version of the Functional Assessment of Cancer Therapy-General (FACT-G)scale.Cancer 88:1715–1727, 2000

    Google Scholar 

  22. Gao YT, Shu XO, Dai Q, Potter JD, Brinton LA, Wen W, Sellers TA, Kushi LH, Ruan Z, Bostick RM, Jin F, Zheng W:Association of menstrual and reproductive factors with breast cancer risk:results from the Shanghai Breast Cancer Study.Int J Cancer 87:295–300,2000

    Google Scholar 

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

    Google Scholar 

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

    Google Scholar 

  25. Vacek PM, Winstead-Fry P, Secker-Walker RH, Hooper GJ, Plante DA:Factors influencing quality of life in breast cancer survivors.Qual Life Res 12:527–537,2003

    Google Scholar 

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

    Google Scholar 

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

    Google Scholar 

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

    Google Scholar 

  29. 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

    Google Scholar 

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

    Google Scholar 

  31. Northouse LL, Walker J, Schafenacker A, Mood D, Mellon S, Galvin E, Harden J, Freeman-Gibb L:A family-based program of care for women with recurrent breast cancer and their family members.Oncol Nurs Forum 29:1411–1419,2002

    Google Scholar 

  32. Jacobson JA, Danforth DN, Cowan KH, d 'Angelo T, Steinberg SM, Pierce L, Lippman ME, Lichter AS, Glatstein E, Okunieff P:Ten-year results of a comparison of conservation with mastectomy in the treatment of stage I and II breast cancer.N Engl J Med 332:907–911, 1995

    Google Scholar 

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

    Google Scholar 

  34. Kiebert GM, de Haes JC, van de Velde CJ:The impact of breast-conserving treatment and mastectomy on the quality of life of early-stage breast cancer patients:a review.J Clin Oncol 9:1059–1070,1991

    Google Scholar 

  35. Moyer A:Psychosocial outcomes of breast-conservation surgery versus mastectomy:a meta-analytic review.Health Psycol 16:284–289,1997

    Google Scholar 

  36. Dorval M, Maunsell E, Deschenes L, Brisson J:Type of mastectomy and quality of life for long term breast carcinoma survivors.Cancer 83:2130–2138,1998

    Google Scholar 

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

    Google Scholar 

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

    Google Scholar 

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

    Google Scholar 

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

    Google Scholar 

  41. Hurny C, Bernhard J, Coates AS, Castiglione-Gertsch M, Peterson HF, Gelber RD, Forbes JF, Rudenstam CM, Simoncini E, Crivellari D, Goldhirsch A, Senn HJ:Impact of adjuvant therapy on quality of life in women with nodepositive operable breast cancer.International Breast Cancer Study Group.Lancet 347:1279–1284,1996

    Google Scholar 

  42. Macquart-Moulin G, Viens P, Genre D, Bouscary ML, Resbeut M, Gravis G, Camerlo J, Maraninchi D, Moatti JP:Concomitant chemoradiotherapy for patients with nonmetastatic breast carcinoma:side effects,quality of life, and organization.Cancer 85:2190–2199,1999

    Google Scholar 

  43. Whelan TJ, Levine M, Julian J, Kirkbride P, Skingley P: 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, 2000

    Google Scholar 

  44. 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:National Institutes of Health Consensus Development Conference Statement:adjuvant therapy for breast cancer,November 1–3,2000.J Natl Cancer Inst 93:979–89,2001

    Google Scholar 

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Authors and Affiliations

  1. Department of Medicine, Center for Health Services Research and Vanderbilt-Ingram Cancer Center, Vanderbilt University, Nashville, TN, USA

    Yong Cui, Hui Cai, Wanqing Wen & Wei Zheng

  2. Department of Medicine, Vanderbilt University, Center for Health Services Research, 6th floor, Medical Center East, Nashville, TN 37232-8300, USA; Tel.:

    Xiao-Ou Shu

  3. Department of Epidemiology, Shanghai Cancer Institute, Shanghai, China

    Yutang Gao, Zhi-Xian Ruan & Fan Jin

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  1. Yong Cui
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Cui, Y., Shu, XO., Gao, Y. et al. 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 (2004). https://doi.org/10.1023/B:BREA.0000041620.76871.97

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