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. 2023 Jun;26(3):243-253.
doi: 10.4048/jbc.2023.26.e23. Epub 2023 May 11.

Predictors of Decreased Quality of Life in Breast Cancer Survivors Five Years After Diagnosis

Saskia-Laureen Herbert  1 , Felix Flock  2 , Ricardo Felberbaum  3 , Wolfgang Janni  4 , Sanja Löb  5 , Matthias Kiesel  5 , Tanja Schlaiß  5 , Joachim Diessner  5 , Carolin Curtaz  5 , Ralf Joukhadar  5 , Davut Dayan  4 , Lukas Schwentner  4 , Susanne Singer  6 , Achim Wöckel  5 ; BRENDA Study Group
Affiliations

Predictors of Decreased Quality of Life in Breast Cancer Survivors Five Years After Diagnosis

Saskia-Laureen Herbert et al. J Breast Cancer. 2023 Jun.

Abstract

Purpose: Due to improved therapy, early diagnosis, and growing incidence rates, the number of long-term breast cancer survivors is increasing. Survivors can still be affected by aftercare, resulting in reduced quality of life (QoL). Thus, in this study, we investigated possible predictors of decreased physical and social functioning in breast cancer survivors.

Methods: In a German multicenter prospective study, we enrolled 759 female patients with breast cancer before surgery (t1), and contacted them again 5 years after surgery (t4). Data on QoL were assessed at t4 using the European Organization for Research and Treatment of Cancer QoL Core Questionnaire (EORTC QLQ-C30) and its breast cancer module EORTC QLQ-BR23. Predictors of decreased physical and social functioning were analyzed using logistic regression with odds ratios as effect estimates and 95% confidence intervals. Thresholds for the clinical importance of detrimental effects on QoL were defined according to Giesinger.

Results: Questionnaires from 759 patients were retrieved at t1. Of these, 456 participated in the study at t4. Poor QoL 5 years after diagnosis was reported by 20%-50% of the participants. Age, mastectomy, chemotherapy, education, employment, cohabitation, psychiatric comorbidities at t1, anxiety, depression, and intensity of physical activity emerged as predictors of decreased physical and social functioning 5 years after diagnosis.

Conclusion: Relief of symptoms and improvement in the QoL should be priorities in aftercare. Detecting patients with a decreased QoL is a rising challenge. Healthcare providers should take special care of patients aged 50-59 years, patients with psychiatric comorbidities and depression, and patients who have undergone mastectomy.

Keywords: Aftercare; Breast Neoplasms; Quality of Life; Survivors.

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Conflict of interest statement

Prof. Singer has received speaker honorarium from Company Lilly and Pfizer. PD Dr. med. Schlaiß has received honorarium from Company Roche, Pfizer, AstraZeneca, Novartis and travel expenses from Celgene. Dr. med. Curtaz joined a mentee program from Novartis and Besins Health.

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