Summary
Purpose. Aim was to compare the functional status in long-term breast cancer survivors related to age at diagnosis and to asses the effects of adjuvant therapy on health-related quality of life (HRQoL).
Patients and methods. Data were obtained from 370 patients after breast conserving therapy (BCT) at follow-up (F/U) visit. The self-administered EORTC QoL questionnaire (C30) and the breast module (QLQ-BR23) measuring global health, global QoL, physical, role, emotional, cognitive and social functioning, body image, sexual function, future perspective and arm/breast symptoms were used. Patients were grouped according to F/U (12 years, 7 years), age at therapy (< 50 years, 50–65 years, >65 years) and adjuvant treatment (none, chemotherapy, hormone replacement therapy).
Results. The global HRQoL was increased in patients with longer F/U (p < 0.01). Physical functioning, role functioning and sexual functioning were decreased in patients being older at therapy (> 65 years, p < 0.01). Increased arm symptoms were noticed in older women at longer follow-up. Younger women at therapy complained financial difficulties at follow-up (p < 0.006). Adjuvant chemotherapy and hormone replacement therapy did not affect physical and mental functioning.
Conclusion. Women of different age treated with BCT for breast cancer should be considered at a different risk for HRQoL disturbance at long term F/U in both, physical and psychological dimensions. In clinical practice, specific identification of those women with negative impact of diagnosis and treatment on long term HRQoL would help for targeted interventions. In clinical studies focusing on HRQoL, the compared groups need to be age-adjusted.
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References
RT Greenlee T Murray S Bolden PA Wingo (2000) ArticleTitleCancer statistics CA Cancer J Clin 50 7–33 Occurrence Handle10735013
P Mosconi M Colloza M Laurentiis ParticleDe S Placido ParticleDe M Maltoni (2001) ArticleTitleSurvival, quality of life and breast cancer Ann Oncol 12 15–19 Occurrence Handle10.1023/A:1013082612737
PA Ganz GA Greendale L Petersen B Kahn JE Bower (2003) ArticleTitleBreast cancer in younger women: reproductive and late health effects of treatment J Clin Oncol 21 4184–4193 Occurrence Handle10.1200/JCO.2003.04.196 Occurrence Handle14615446
PA Ganz E Guadagnoli MB Landrum TL Lash W Rakowski RA Silliman (2003) ArticleTitleBreast cancer in older women: quality of life and psychosocial adjustment in the 15 months after diagnosis J Clin Oncol 21 4027–4033 Occurrence Handle10.1200/JCO.2003.08.097 Occurrence Handle14581426
CH Kroenke B Rosner WY Chen I Kawachi GA Colditz MD Holmes (2004) ArticleTitleFunctional impact of breast cancer by age at diagnosis J Clin Oncol 22 1849–1856 Occurrence Handle10.1200/JCO.2004.04.173 Occurrence Handle15143077
LB Wenzel DL Fairclough MJ Brady D Cella KM Garrett BC Kluhsman LA Crane AC Marcus (1999) ArticleTitleAge-related differences in the quality of life of breast carcinoma patients after treatment Cancer 86 1768–1774 Occurrence Handle10.1002/(SICI)1097-0142(19991101)86:9<1768::AID-CNCR19>3.0.CO;2-O Occurrence Handle10547550
NK Arora DH Gustafson RP Hawkins F McTavish DF Cella S Pingree JH Mendenhall DM Mahvi (2001) ArticleTitleImpact of surgery and chemotherapy on the quality of life of younger women with breast carcinoma: a prospective study Cancer 92 1288–1298 Occurrence Handle10.1002/1097-0142(20010901)92:5<1288::AID-CNCR1450>3.0.CO;2-E Occurrence Handle11571745
EM Durna SM Crowe LR Leader JA Eden (2002) ArticleTitleQuality of life of breast cancer survivors: the impact of hormonal replacement therapy Climacteric 5 266–276 Occurrence Handle12419085
AD Vinokur BA Threatt RD Caplan BL Zimmerman (1989) ArticleTitlePhysical and psychosocial functioning and adjustment to breast cancer. Long term follow-up of a screening population Cancer 63 394–405 Occurrence Handle2910447
PA Ganz JH Rowland K Desmond BE Meyerowitz GE Wyatt (1998) ArticleTitleLife after breast cancer: understanding women’s health-related quality of life and sexual functioning J Clin Oncol 16 IssueID2 501–514 Occurrence Handle9469334
NK Aaronson S Ahmedzai B Bergman M Bullinger A Cull NJ Duez A Filiberti H Flechtner SB Fleishman JC Haes Particlede (1993) ArticleTitle The European Organization for Research and Treatment of Cancer QLQ-30: A quality of life instrument for use in international clinical trials in oncology J Natl Cancer Inst 85 365–376 Occurrence Handle8433390
P Fayers A Bottomley (2002) ArticleTitleOn behalf of the EORTC Quality of Life Group and the Quality of Life Unit: Quality of life research within the EORTC- the EORTC QLQ-C30 Eur J Cancer 38 125–13 Occurrence Handle10.1016/S0959-8049(01)00448-8
MAG Sprangers M Groenvold JI Arraras J Franklin A te Velde M Muller L Franzini A Williams HC Haes Particlede P Hopwood A Cull NK Aaronson (1996) ArticleTitleThe European Organization for Research and Treatment of Cancer breast cancer-specific quality-of-life questionnaire module: first results from three-country field study J Clin Onc 14 2756–2768
P Fayers N Aaronson K Bjordal (2001) EORTC QLQ-C30 Scoring Manual EORTC Brussels
JR Bloom SL Stewart S Chang PJ Banks (2004) ArticleTitleThen and now: quality of life of young breast cancer survivors Psychooncology 13 147–160 Occurrence Handle15022150
PA Ganz A Coscarelli C Fred B Kahn ML Polinsky L Petersen (1996) ArticleTitleBreast cancer survivors: psychosocial concerns and quality of life Breast Cancer Res Treat 38 183–199 Occurrence Handle10.1007/BF01806673 Occurrence Handle8861837
J Mandelblatt M Figueiredo J Cullen (2003) ArticleTitleOutcomes and quality of life following breast cancer treatment in older women: When, why, how much, and what do women want? Health Qual Life Outcomes 17 45–56 Occurrence Handle10.1186/1477-7525-1-45
L Repetto G Ausili-Cefaro C Gallo A Rossi L Manzione (2001) ArticleTitleQuality of life in elderly cancer patients Ann Oncol 12 IssueIDS3 49–52 Occurrence Handle10.1023/A:1013095015463
SJT Jansen AM Stiggelbout MA Nooij EM Noordijk J Kievit (2000) ArticleTitleResponse shift in quality of life measurement in early-stage breast cancer patients undergoing radiotherapy Quality of Life Res 9 603–615 Occurrence Handle10.1023/A:1008928617014
CE Schwartz MAG Sprangers (1999) ArticleTitleMethodological approaches for assessing response shift in longitudinal health-related quality-of-life research Soc Sci Med 48 1531–1548 Occurrence Handle10.1016/S0277-9536(99)00047-7 Occurrence Handle10400255
FM Fang HC Chiu WR Kuo CJ Wang SW Leung HC Chen LM Sun HC Hsu (2002) ArticleTitleHealth-related quality of life for nasopharyngeal carcinoma patients with cancer-free survival after treatment Int J Radiat Oncol Biol Phys 53 959–968 Occurrence Handle10.1016/S0360-3016(02)02838-9 Occurrence Handle12095563
J Bernhard C Hurny AS Coates HF Peterson M Castiglione–Gertsch RD Gelber A Goldhirsch HJ Senn CM Rudenstam (1998) ArticleTitleFactors affecting baseline quality of life in two international adjuvant breast cancer trials. International Breast Cancer Study Group (IBCSG) Br J Cancer 78 686–693 Occurrence Handle9744512
F Joly M Espie M Marty JF Heron M Henry–Amar (2000) ArticleTitleLong term quality of life in premenopausal women with node-negative localized breast cancer treated with or without adjuvant chemotherapy Br J Cancer 83 577–582 Occurrence Handle10.1054/bjoc.2000.1337 Occurrence Handle10944595
JE Bower PA Ganz KA Desmond JH Rowland BE Meyerowitz TR Belin (2000) ArticleTitleFatigue in breast cancer survivors: occurrence, correlates, and impact on quality of life J Clin Oncol 18 743–753 Occurrence Handle10673515
G Berglund C Bolund T Fornander LE Rutqvist PO Sjoden (1991) ArticleTitleLate effects of adjuvant chemotherapy and postoperative radiotherapy on quality of life among breast cancer patients Eur J Cancer 27 1075–1081 Occurrence Handle1683557
KH Dow BT Ferrell S Leigh (1996) ArticleTitleAn evaluation of the quality of life among long term survivors of breast cancer Breast Cancer Res Treat 39 261–273 Occurrence Handle10.1007/BF01806154 Occurrence Handle8877006
BE Meyerowitz IK Watkins FC Sparks (1983) ArticleTitlePsychosocial implications of adjuvant chemotherapy: a two-year follow-up Cancer 52 1541–1545 Occurrence Handle6616414
B Holzner G Kemmler M Kopp R Moschen H Schweigkofler M Dunser R Margreiter WW Fleischhacker B Sperner–Unterweger et al. (2001) ArticleTitleQuality of life in breast cancer patients – not enough attention for long term survivors? Psychosomatics 42 117–23 Occurrence Handle10.1176/appi.psy.42.2.117 Occurrence Handle11239124
G Kemmler B Holzner M Kopp M Dunser R Margreiter R Greil B Sperner-Unterweger (1999) ArticleTitleComparison of two quality of life instruments for cancer patients: The functional assessment of cancer therapy-general and the European Organization for Research and Treatment of Cancer quality of life questionnaire-C30 J Clin Oncol 17 2932–2940 Occurrence Handle10561373
CC Gotay MY Muraoka (1998) ArticleTitleQuality of life in long term survivors of adult-onset cancers J Natl Cancer Inst 90 656–667 Occurrence Handle10.1093/jnci/90.9.656 Occurrence Handle9586662
CM Moinpour (1994) ArticleTitleMeasuring quality of life: an emerging science Semin Oncol 21 48–63
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Fehlauer, F., Tribius, S., Mehnert, A. et al. Health-Related Quality of Life in Long Term Breast Cancer Survivors Treated with Breast Conserving Therapy: Impact of Age at Therapy. Breast Cancer Res Treat 92, 217–222 (2005). https://doi.org/10.1007/s10549-005-2420-2
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DOI: https://doi.org/10.1007/s10549-005-2420-2