Skip to main content

Advertisement

SpringerLink
Log in

Factors associated with health-related quality of life in a cohort of Spanish breast cancer patients

  • Original Article
  • Published:
Breast Cancer Aims and scope Submit manuscript

Abstract

Background

Several factors can modify health-related quality of life (HRQOL) of breast cancer survivors. The objective of the current study was to analyse the associations between HRQOL scores 1 year after breast cancer surgery and sociodemographic and clinical factors.

Methods

This was an observational, multicentre and prospective study of a cohort of patients who underwent oncological breast cancer surgery and which was followed up for 1 year. The HRQOL was assessed at 1 year after surgery using three questionnaires: EuroQol-5D, EORTC QLQ-C30 and its breast-specific module BR-23.

Results

A total of 364 patients participated in the study. Some factors were associated with better HRQOL 1 year after surgery: age between 60 and 69 years and under 50 years, being single or a housewife, stage I–II, invasive papillary carcinoma, breast-conserving surgery (BCS) or lack of axillary dissection. However, only the following were independent predictive factors: being single or a housewife, BCS, invasive papillary carcinoma, coming from an outpatient clinic or not receiving radiotherapy. Further, some factors were independent predictors of a worse HRQOL: age over 70 years, being married, separated or widowed, stage III or not receiving adjuvant chemotherapy.

Conclusions

Demographic and clinical factors can influence HRQOL, some of them independently.

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

Access this article

Log in via an institution

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

Abbreviations

BCS:

Breast-conserving surgery

DCIS:

Ductal carcinoma in situ

EORTC:

European Organization for Research and Treatment of Cancer

EuroQol-5D:

European Group of Quality of Life Questionnaire

HRQOL:

Health-related quality of life

LCIS:

Lobular carcinoma in situ

QLQ-BR23:

Quality of Life Questionnaire Breast 23 items

QLQ-C30:

Quality of Life Questionnaire 30 items

SLNB:

Sentinel lymph node biopsy

VAS:

Visual analogue scale

References

  1. Moore FD, VanDevanter SB, Boyden CM, Lokich J, Wilson RE. Adrenalectomy with chemotherapy in the treatment of advanced breast cancer: objective and subjective response rates; duration and quality of life. Surgery. 1974;76(3):376–90.

    CAS  PubMed  Google Scholar 

  2. The WHOQOL Group (1996). World Health Organization Quality of Life Assessment. What quality of life? World Health Forum. 17(4):354–6.

  3. Veronesi U, Cascinelli N, Mariani L, Greco M, Saccozzi R, Luini A, et al. Twenty-year follow-up of a randomized study comparing breast-conserving surgery with radical mastectomy for early breast cancer. N Engl J Med. 2002;347(16):1227–32.

    Article  PubMed  Google Scholar 

  4. Poggi MM, Danforth DN, Sciuto LC, Smith SL, Steinberg SM, Liewehr DJ, et al. Eighteen-year results in the treatment of early breast carcinoma with mastectomy versus breast conservation therapy: the National Cancer Institute Randomized Trial. Cancer. 2003;98(4):697–702.

    Article  PubMed  Google Scholar 

  5. Majewski JM, Lopes AD, Davoglio T, Leite JC. Quality of life of women recovering from breast cancer after being subjected to mastectomies compared to those who had conservative surgery: a review of the literature. Cien Saude Colet. 2012;17(3):707–16.

    Article  PubMed  Google Scholar 

  6. Arndt V, Stegmaier C, Ziegler H, Brenner H. Quality of life over 5 years in women with breast cancer after breast-conserving therapy versus mastectomy: a population-based study. J Cancer Res Clin Oncol. 2008;134(12):1311–8.

    Article  PubMed  Google Scholar 

  7. 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. 2002;94(1):39–49.

    Article  PubMed  Google Scholar 

  8. Härtl K, Janni W, Kästner R, Sommer H, Strobl B, Rack B, et al. Impact of medical and demographic factors on long-term quality of life and body image of breast cancer patients. Ann Oncol. 2003;14(7):1064–71.

    Article  PubMed  Google Scholar 

  9. Peuckmann V, Ekholm O, Rasmussen NK, Moller S, Groenvold M, Christiansen P, et al. Health-related quality of life in long-term breast cancer survivors: nationwide survey in Denmark. Breast Cancer Res Treat. 2007;104(1):39–46.

    Article  PubMed  Google Scholar 

  10. Pockaj BA, Degnim AC, Boughey JC, Gray RJ, McLaughlin SA, Dueck AC, et al. Quality of life after breast cancer surgery: what have we learned and where should we go next? J Surg Oncol. 2009;99(7):447–55.

    Article  PubMed  Google Scholar 

  11. Rabin R, Oemar M, Oppe M. EQ-5D-5L User Guide. Basic information on how to use the EQ-5D-5L instrument. 2011. http://www.euroqol.org/fileadmin/user_upload/Documenten/PDF/Folders_Flyers/UserGuide_EQ-5D-5L.pdf. Accessed 18 May 2012.

  12. Young T, de Haes HC, Curran D. Guidelines for assessing quality of life in EORTC clinical trials. Brussels: EORTC Quality of Life Group; 2002.

    Google Scholar 

  13. Fayers PM, Aaronson NK, Bjordal K, Groenvold M, Curran D, Bottomley A. The EORTC QLQ-C30 scoring manual. 2001. http://www.eortc.be/home/qol/files/SCManualQLQ-C30.pdf. Accessed 18 May 2012.

  14. Hopwood P, Haviland J, Mills J, Sumo G, Bliss MJ. START Trial Management Group. The impact of age and clinical factors on quality of life in early breast cancer: an analysis of 2208 women recruited to the UK START Trial (Standardisation of Breast Radiotherapy Trial). Breast. 2007;16(3):241–51.

    Google Scholar 

  15. Delgado-Sanz MC, García-Mendizábal MJ, Pollán M, Forjaz MJ, López-Abente G, Aragonés N, et al. Heath-related quality of life in Spanish breast cancer patients: a systematic review. Health Qual Life Outcomes. 2011;9:3.

    Article  PubMed Central  PubMed  Google Scholar 

  16. Schou I, Ekeberg O, Sandvik L, Hjermstad MJ, Ruland CM. Multiple predictors of health-related quality of life in early stage breast cancer. Data from a year follow-up study compared with the general population. Qual Life Res. 2005;14(8):1813–23.

    Article  PubMed  Google Scholar 

  17. Pandey M, Thomas BC, Ramdas K, Ratheesan K. Early effect of surgery on quality of life in women with operable breast cancer. Jpn J Clin Oncol. 2006;36(7):468–72.

    Article  PubMed  Google Scholar 

  18. Ganz PA, Kwan W, Stanton AL, Krupnick JL, Rowland JH, Meyerowitz BE, et al. Quality of life at the end of primary treatment of breast cancer: first results from the moving beyond cancer randomized trial. J Natl Cancer Inst. 2004;96(5):376–87.

    Article  PubMed  Google Scholar 

  19. Cohen L, Hack TF, de Moor C, Katz J, Goss PE. The effects of type of surgery and time on psychological adjustment in women after breast cancer treatment. Ann Surg Oncol. 2000;7(6):427–34.

    Article  CAS  PubMed  Google Scholar 

  20. Dorval M, Maunsell E, Deschênes L, Brisson J. Type of mastectomy and quality of life for long term breast carcinoma survivors. Cancer. 1998;83(10):2130–8.

    Article  CAS  PubMed  Google Scholar 

  21. Gorisek B, Krajnc P, Krajnc I. Quality of life and the effect on social status among Slovenian women after breast cancer treatment. J Int Med Res. 2009;37(2):557–66.

    Article  CAS  PubMed  Google Scholar 

  22. Härtl K, Engel J, Herschbach P, Reinecker H, Sommer H, Friese K. Personality traits and psychosocial stress: quality of life over 2 years following breast cancer diagnosis and psychological impact factors. Psychooncology. 2010;19(2):160–9.

    Article  PubMed  Google Scholar 

  23. Collins KK, Liu Y, Schootman M, Aft R, Yan Y, Dean G, et al. Effects of breast cancer surgery and surgical side effects on body image over time. Breast Cancer Res Treat. 2011;126(1):167–76.

    Article  PubMed Central  PubMed  Google Scholar 

  24. Lam WW, Li WW, Bonanno GA, Mancini AD, Chan M, Or A, et al. Trajectories of body image and sexuality during the first year following diagnosis of breast cancer and their relationship to 6 years psychosocial outcomes. Breast Cancer Res Treat. 2012;131(3):957–67.

    Article  PubMed  Google Scholar 

  25. Huguet PR, Morais SS, Osis MJ, Pinto-Neto AM, Gurgel MS. Quality of life and sexuality of women treated for breast cancer. Rev Bras Ginecol Obstet. 2009;31(2):61–7.

    Article  PubMed  Google Scholar 

  26. Den Oudsten BL, Van Heck GL, Van der Steeg AF, Roukema JA, De Vries J. Clinical factors are not the best predictors of quality of sexual life and sexual functioning in women with early stage breast cancer. Psychooncology. 2010;19(6):646–56.

    Article  Google Scholar 

  27. Howard-Anderson J, Ganz PA, Bower JE, Stanton AL. Quality of life, fertility concerns, and behavioural health outcomes in younger breast cancer survivors: a systematic review. J Natl Cancer Inst. 2012;104(5):386–405.

    Article  PubMed  Google Scholar 

  28. Pumo V, Milone G, Iacono M, Guiliano SR, Di Mari A, Lopiano C, et al. Psychological and sexual disorders in long-term breast cancer survivors. Cancer Manag Res. 2012;4:61–5.

    PubMed Central  PubMed  Google Scholar 

  29. Tsai RJ, Dennis LK, Lynch CF, Snetselaar LG, Zamba GK, Scott-Conner C. The risk of developing arm lymphedema among breast cancer survivors: a meta-analysis of treatment factors. Ann Surg Oncol. 2009;16(7):1959–72.

    Article  PubMed  Google Scholar 

  30. Hayes SC, Janda M, Cornish B, Battistutta D, Newman B. Lymphedema after breast cancer: incidence, risk factors, and effect on upper body function. J Clin Oncol. 2008;26(21):3536–42.

    Article  PubMed  Google Scholar 

  31. Nesvold IL, Dahl AA, Lokkevik E, Marit Mengshoel A, Fossa SD. Arm and shoulder morbidity in breast cancer patients after breast-conserving therapy versus mastectomy. Acta Oncol. 2008;47(5):835–42.

    Google Scholar 

  32. Park BW, Lee S, Lee AR, Lee KH, Hwang SY. Quality of life differences between younger and older breast cancer patients. J Breast Cancer. 2011;14(2):112–8.

    Article  PubMed Central  PubMed  Google Scholar 

  33. Janz NK, Mujahid M, Lantz PM, Fagerlin A, Salem B, Morrow M, et al. Population-based study of the relationship of treatment and sociodemographics on quality of life for early stage breast cancer. Qual Life Res. 2005;14(6):1467–79.

    Article  PubMed  Google Scholar 

  34. Bulotiene G, Veseliunas J, Ostapenko V. Quality of life of Lithuanian women with early stage breast cancer. BMC Public Health. 2007;7:124.

    Article  PubMed Central  PubMed  Google Scholar 

  35. Parker PA, Youssef A, Walker S, Basen-Engguist K, Cohen L, Gritz ER, et al. Short-term and long-term psychosocial adjustment and quality of life in women undergoing different surgical procedures for breast cancer. Ann Surg Oncol. 2007;14(11):3078–89.

    Article  PubMed  Google Scholar 

  36. Bloom JR, Petersen DM, Kang SH. Multi-dimensional quality of life among long-term (5+ years) adult cancer survivors. Psychooncology. 2007;16(8):691–706.

    Article  PubMed  Google Scholar 

  37. Ahn E, Cho J, Shin DW, Park BW, Ahn SH, Noh DY, et al. Impact of breast cancer diagnosis and treatment on work-related life and factors affecting them. Breast Cancer Res Treat. 2009;116(3):609–16.

    Article  PubMed  Google Scholar 

  38. Maunsell E, Drolet M, Brisson J, Brisson C, Mâsse B, Deschênes L. Work situation after breast cancer: results from a population-based study. J Natl Cancer Inst. 2004;96(24):1813–22.

    Article  PubMed  Google Scholar 

  39. Montazeri A. Health-related quality of life in breast cancer patients: a bibliographic review of the literature from 1974 to 2007. J Exp Clin Cancer Res. 2008;27:32.

    Article  PubMed Central  PubMed  Google Scholar 

  40. Avis NE, Crawford S, Manuel J. Quality of life among younger women with breast cancer. J Clin Oncol. 2005;23(15):3322–30.

    Article  PubMed  Google Scholar 

  41. Wang Z, Wu LC, Chen JQ. Sentinel lymph node biopsy compared with axillary lymph node dissection in early breast cancer: a meta-analysis. Breast Cancer Res Treat. 2011;129(3):675–89.

    Article  PubMed  Google Scholar 

  42. Mols F, Vingerhoets AJ, Coebergh JW, van de Poll-Franse LV. Quality of life among long-term breast cancer survivors: a systematic review. Eur J Cancer. 2005;41(17):2613–9.

    Google Scholar 

  43. Ganz PA, Kwan L, Stanton AL, Bower JE, Belin TR. Physical and psychosocial recovery in the year after primary treatment of breast cancer. J Clin Oncol. 2011;29(9):1101–9.

    Article  PubMed Central  PubMed  Google Scholar 

  44. Sprangers MA, Schwartz CE. Integrating response shift into health-related quality of life research: a theoretical model. Soc Sci Med. 1999;48(11):1507–15.

    Article  CAS  PubMed  Google Scholar 

  45. Dabakuyo TS, Guillemin F, Conroy T, Velten M, Jolly D, Mercier M, et al. Response shift effects on measuring post-operative quality of life among breast cancer patients: a multicenter cohort study. Qual Life Res. 2012. doi:10.1007/s11136-012-0135-5.

  46. Prescott RJ, Kunkler IH, Williams LJ, King CC, Jack W, van der Pol M, et al. A randomised controlled trial of postoperative radiotherapy following breast-conserving surgery in a minimum-risk older population. The PRIME trial. Health Technol Assess. 2007;11(31):1–149.

    CAS  PubMed  Google Scholar 

  47. Reindunsdatter RJ, Rannestad T, Frengen J, Frykholm G, Lundgren S. Early effects of contemporary breast radiation on health-related quality of life—predictors of radiotherapy-related fatigue. Acta Oncol. 2011;50(8):1175–82.

    Article  Google Scholar 

  48. Scott NW, Fayers PM, Aaronson NK, Bottomley A, de Graeff A, Groenvold M, et al. The EORTC-C30 reference values manual. 2008. http://groups.eortc.be/qol/downloads/reference_values_manual2008.pdf. Accessed 18 May 2012.

  49. Schreiber JA, Brockopp DY. Twenty-five years later—what do we know about religion/spirituality and psychological well-being among breast cancer survivors? A systematic review. J Cancer Surviv. 2012;6(1):82–94.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Surgery, Hospital Clínico Universitario de Valencia, Valencia, Spain

    David Moro-Valdezate, Antonio Caballero-Gárate, Ángel Martínez-Agulló & Joaquín Ortega-Serrano

  2. Department of Surgery, Hospital de Sagunto, Valencia, Spain

    Elvira Buch-Villa & Félix Checa-Ayet

  3. Health Services Research Unit, Centro Superior de Investigación en Salud Pública (CSISP), Valencia, Spain

    Salvador Peiró

  4. Department of Surgery, Hospital Universitario Doctor Peset de Valencia, Valencia, Spain

    M. Dolores Morales-Monsalve

  5. C/General San Martín, 24-4, 46004, Valencia, Spain

    David Moro-Valdezate

Authors
  1. David Moro-Valdezate
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Elvira Buch-Villa
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Salvador Peiró
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. M. Dolores Morales-Monsalve
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Antonio Caballero-Gárate
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Ángel Martínez-Agulló
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Félix Checa-Ayet
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Joaquín Ortega-Serrano
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to David Moro-Valdezate.

About this article

Cite this article

Moro-Valdezate, D., Buch-Villa, E., Peiró, S. et al. Factors associated with health-related quality of life in a cohort of Spanish breast cancer patients. Breast Cancer 21, 442–452 (2014). https://doi.org/10.1007/s12282-012-0402-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12282-012-0402-x

Keywords

Search

Navigation