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. 2023 Oct;17(5):1416-1426.
doi: 10.1007/s11764-022-01165-4. Epub 2022 Mar 12.

Long-term trajectory of postoperative health-related quality of life in young breast cancer patients: a 15-year follow-up study

Thi Xuan Mai Tran  1 , So-Youn Jung  2 , Eun-Gyeong Lee  2 , Heeyoun Cho  3 , Juhee Cho  4 , Eunsook Lee  2   5 , Yoon Jung Chang #  6   7 , Hyunsoon Cho #  8   9
Affiliations

Long-term trajectory of postoperative health-related quality of life in young breast cancer patients: a 15-year follow-up study

Thi Xuan Mai Tran et al. J Cancer Surviv. 2023 Oct.

Abstract

Purpose: Breast cancer (BC) patients often experience various long-term sequelae due to aggressive treatment. We analyzed and illustrated long-term trajectory during different phases of treatment and survivorship.

Methods: Data were obtained from a cohort of 298 BC patients diagnosed between 2004 and 2006 and were followed up until 2020. We measured HRQoL using EORTC QLQ-C30, QLQ-BR23, and EuroQoL-5D questionnaires and conducted eight assessments right after initial diagnosis, during treatment, post-treatment, and during survivorship phases. Linear mixed model was used to assess changes in HRQoL. Overall HRQoL measured by EQ-5D index of long-term BC survivors were further compared with that of the age-matched general population.

Results: Of 298 participants, 246 women survived and 124 participated in the long-term follow-up survey (LTFU). Overall, HRQoL functions deteriorated during treatment but gradually improved between 1- and 3-year post-diagnosis and stabilized over LTFU measure. Significant recovery was observed in physical, role, emotional, social functions, and future perspectives (p < 0.05). Treatment-related acute symptoms were reported in the first year but diminished afterward, and treatment-related financial difficulties lessened. At LTFU, BC survivors reported a high level of insomnia, fatigue, and pain and appeared to have poorer overall HRQoL than the general population (mean difference, EQ-5D index: 0.073, p < 0.001).

Conclusions: Through 15-year survivorship, BC survivors showed improvement in many aspects of HRQoL. However, some inferior aspects remain relevant for long-term survivors. Ongoing supportive programs concentrating on pain management, persistent cancer-related fatigue, and sleeping problems might aid enhance their HRQoL.

Keywords: Breast cancer; Health-related quality of life; Long-term cancer survivors; Pain; Fatigue; Insomnia.

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