Summary
A growing of research documents the negative impact of recurrent breast cancer on quality of life (QOL), however few prospective investigations are available that compare QOL outcomes across different types of second cancer events (e.g., local/regional recurrence (LR) versus distant/metastatic recurrence (DR) versus a new primary breast cancer (NP)). In addition, although participant attrition is a major issue in this group of cancer patients, the potential impact of attrition or response bias on QOL outcomes is not typically examined. To address these issues, we prospectively examined QOL data obtained from a sample of women (n=140) participating in the Women’s Healthy Eating and Living (WHEL) Study who experienced a second cancer event (LR, DR or NP). Women in our study reported significant worsening in most areas of QOL, except for emotional wellbeing, from pre- to post-second cancer event. Although the patterns of change to QOL differed slightly within each category (LR versus DR versus NP), participants were more similar than different in their QOL ratings. However, the perceived health status of women with DR was significantly lower than women with LR or NP. We also identify important sources of response bias that should be considered when interpreting findings. Specifically, women diagnosed with DR (a) were more likely to decline to complete the post-recurrence QOL questionnaire (27% refusal rate versus 14% LR and 13% NP), and (b) had higher death rates (28% death rate versus 4% LR and 6% NP) after agreeing to but before completing the post-second diagnosis QOL questionnaire.
Similar content being viewed by others
References
American Cancer Society: Cancer Facts and Figures – 2004. Atlanta, Author, 2004
CC Gotay (1984) ArticleTitleThe experience of cancer during early and advanced stages: the views of patients and their mates Soc Sci Med 18 605–613 Occurrence Handle10.1016/0277-9536(84)90076-5 Occurrence Handle1:STN:280:BiuC1MnlsVY%3D Occurrence Handle6719154
SM Spencer JM Lehman C Wynings P Arena CS Carver MH Antoni RP Derhagopian G Ironson N Love (1999) ArticleTitleConcerns about breast cancer and relations to psychosocial well-being in a multiethnic sample of early-stage patients Health Psychol 18 159–168 Occurrence Handle1:STN:280:DyaK1M3gvVeqtg%3D%3D Occurrence Handle10194051
RJ Santiago L Wu E Harris K Fox D Schultz J Glick LJ Solin (2004) ArticleTitleFifteen-year results of breast-conserving surgery and definitive irradiation for Stage I and II breast carcinoma: the University of Pennsylvania experience Int J Radiat Oncol Biol Phys 1 2333–2340
T Saphner DC Tormey R Gray (1996) ArticleTitleAnnual hazard rates of recurrence for breast cancer after primary therapy J Clin Oncol 14 2738–2746 Occurrence Handle1:STN:280:ByiD38fjt1U%3D Occurrence Handle8874335
AC Voogd M Nielsen JL Peterse M Blichert-Toft H Bartelink M Overgaard G Tienhoven Particlevan KW Andersen RJ Sylvester JA Dongen Particlevan (2001) ArticleTitleDanish Breast Cancer Cooperative Group. Breast Cancer Cooperative Group of the European Organisation for Research and Treatment of Cancer: differences in risk factors for local and distant recurrence after breast conserving therapy or masectomy for Stage I and II breast cancer: pooled results of two large European randomized trials J Clin Oncol 19 1688–1697 Occurrence Handle1:STN:280:DC%2BD3M3gsl2nsg%3D%3D Occurrence Handle11250998
J Camilleri-Brennan RJC Steele (2001) ArticleTitleThe impact of recurrent rectal cancer on quality of life Eur J Cancer 27 349–353 Occurrence Handle1:STN:280:DC%2BD3MzlslGktw%3D%3D
MH Frost VJ Suman TA Rummans AM Dose M Taylor P Novotny R Johnson RE Evans (2000) ArticleTitlePhysical, psychological and social well-being of women with breast cancer: the influence of disease phase Psycho-Oncology 9 221–231 Occurrence Handle10.1002/1099-1611(200005/06)9:3<221::AID-PON456>3.0.CO;2-T Occurrence Handle10871718
EP Winer C Lindley M Hardee WT Sawyer C Brunatti NA Borstelmann W Peters (1999) ArticleTitleQuality of life in patients surviving at least 12 months following high dose chemotherapy with autologous bone marrow support Psycho-Oncology 8 167–176 Occurrence Handle10.1002/(SICI)1099-1611(199903/04)8:2<167::AID-PON354>3.0.CO;2-S Occurrence Handle1:STN:280:DyaK1M3mvVSnsw%3D%3D Occurrence Handle10335560
AA Bull BE Meyerowitz S Hart P Mosconi G Apolone A Liberati (1999) ArticleTitleQuality of life in women with recurrent breast cancer Breast Cancer Res Treat 54 47–57 Occurrence Handle10.1023/A:1006172024218 Occurrence Handle1:STN:280:DyaK1M3psFOmtg%3D%3D Occurrence Handle10369080
C Hurny J Bernhard AS Coates M Castiglione-Gertsch HF Peterson RD Gelber JF Forbes CM Rudenstam E Simoncini D Crivellari A Goldhirsch HJ Senn (1996) ArticleTitlefor the International Breast Cancer Study Group: Impact of adjuvant therapy on quality of life in women with node-positive breast cancer Lancet 347 1279–1284 Occurrence Handle1:CAS:528:DyaK28Xjs1eksLY%3D Occurrence Handle8622502
S Oh L Heflin BE Meyerowitz KA Desmond JH Rowland PA Ganz (2004) ArticleTitleQuality of life of breast cancer survivors after a recurrence: a follow-up study Breast Cancer Res Treat 87 45–57 Occurrence Handle10.1023/B:BREA.0000041580.55817.5a Occurrence Handle15377850
PA Ganz KA Desmond B Leedham JH Rowland BE Meyerowitz TR Belin (2002) ArticleTitleQuality of life in long-term, disease-free survivors of breast cancer: a follow-up study J Natl Cancer Inst 94 39–49 Occurrence Handle11773281
JP Pierce S Faerber FA Wright CL Rock V Newman SW Flatt S Kealey VE Jones BJ Caan EB Gold M Haan KA Hollenbach L Jones JR Marshall C Ritenbaugh ML Stefanick C Thomson L Wasserman L Natarajan RG Thomas EA Gilpin (2002) ArticleTitleWomen’s Healthy Eating and Living (WHEL) study group: a randomized trial of the effect of a plant-based dietary pattern on additional breast cancer events and survival: the Women’s Healthy Eating and Living (WHEL) Study Control Clin Trials 23 728–756 Occurrence Handle12505249
American Joint Committee on Cancer: Manual for Staging of Cancer, 4th ed. J.B. Lippincott Company, Philadelphia, PA, 1992
R Hays C Sherbourne R Mazel (1993) ArticleTitleThe Rand 36-Item Health Survey 1.0 Health Economics 2 217–227 Occurrence Handle1:STN:280:ByuC3c7gs1M%3D Occurrence Handle8275167
JE Ware KK Snow M Kosinski B Gandek (2000) SF-36 Health Survey: Manual and Interpretation Guide Lincoln, RI QualityMetric Incorporated
CA McHorney M Kosinksi JE Ware (1994) ArticleTitleComparisons of the costs and quality of norms for the SF-36 Health Survey collected by mail versus telephone interview: results from a national survey Med Care 32 551–567 Occurrence Handle1:STN:280:ByuB2cjgtFQ%3D Occurrence Handle8189774
J Bernhard DF Cella AS Coates L Fallowfield PA Ganz CM Moinpour P Mosconi D Osoba J Simes C Hurny (1998) ArticleTitleMissing quality of life data in cancer clinical trials: serious problems and challenges Stat Med 17 517–532 Occurrence Handle10.1002/(SICI)1097-0258(19980315/15)17:5/7<517::AID-SIM799>3.3.CO;2-J Occurrence Handle1:STN:280:DyaK1c3htV2ksg%3D%3D Occurrence Handle9549801
AE Sales ME Plomondon DJ Magid JA Spertus JS Rumsfeld (2004) ArticleTitleAssessing response bias from missing quality of life data: the Heckman method Health Qual Life Outcome 2 49 Occurrence Handle10.1186/1477-7525-2-49
D Curran G Molenberghs PM Fayers D Machin (1998) ArticleTitleIncomplete quality of life data in randomized trials: missing forms Stat Med 17 697–709 Occurrence Handle10.1002/(SICI)1097-0258(19980315/15)17:5/7<697::AID-SIM815>3.3.CO;2-P Occurrence Handle1:STN:280:DyaK1c3htV2rtA%3D%3D Occurrence Handle9549817
RJ Simes V Greatorex VJ Gebski (1998) ArticleTitlePractical approaches to minimize problems with missing quality of life data Stat Med 17 725–737 Occurrence Handle10.1002/(SICI)1097-0258(19980315/15)17:5/7<725::AID-SIM817>3.3.CO;2-T Occurrence Handle1:STN:280:DyaK1c3htV2rug%3D%3D Occurrence Handle9549819
CM Moinpour J Sawyers Triplett B McKnight (2000) ArticleTitleChallenges posed by non-random missing quality of life data in an advanced-stage colorectal cancer clinical trial Psycho-oncology 9 340–354 Occurrence Handle10.1002/1099-1611(200007/08)9:4<340::AID-PON466>3.0.CO;2-F Occurrence Handle1:STN:280:DC%2BD3cvjsValtg%3D%3D Occurrence Handle10960931
Author information
Authors and Affiliations
Consortia
Corresponding author
Rights and permissions
About this article
Cite this article
Thornton, A.A., Madlensky, L., Flatt, S.W. et al. The impact of a second breast cancer diagnosis on health related quality of life. Breast Cancer Res Treat 92, 25–33 (2005). https://doi.org/10.1007/s10549-005-1411-7
Issue Date:
DOI: https://doi.org/10.1007/s10549-005-1411-7