Original Article

Breast Cancer

, 10:204

First online:

Measuring quality of life in patients with breast cancer: a systematic review of reliable and valid instruments available in japan

  • Takahiro OkamotoAffiliated withDepartments of Endocrine SurgeryHygiene and Public Health II, Tokyo Women’s Medical University
  • , Kojiro ShimozumaAffiliated withLnstitute for Scientific Research of Stress, Public Health Research FoundationSchool of Health Sciences and Nursing, Graduate School of Medicine, University of Tokyo
  • , Noriyuki KatsumataAffiliated withDepartment of Medical Oncology, National Cancer Center Hospital
  • , Michiko KoikeAffiliated withCinza Prima Clinic
  • , Akinori HisashigeAffiliated withDepartment of Preventive Medicine, University of Tokushima Graduate School of Medicine
  • , Katsuhiro TanakaAffiliated withDepartment of Surgery, Breast and Thyroid Division, Kawasaki Medical School
  • , Shozo OhsumiAffiliated withDepartment of Surgery, National Shikoku Cancer Center
  • , Mitsue SaitoAffiliated withDepartment of Breast Surgery, National Cancer Center Research Institute
  • , Naoto ShikamaAffiliated withDepartment of Radiology, Shinshu University School of Medicine
    • , Michihide MitsumoriAffiliated withDepartment of Therapeutic Radiology and Oncology, Kyoto University Graduate School of Medicine
    • , Chikako YamauchiAffiliated withDepartment of Therapeutic Radiology and Oncology, Kyoto University Graduate School of Medicine
    • , Takanori WatanabeAffiliated withDepartment of Surgery II, Fukushima Medical University School of Medicine

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Little is known about the availability and psychometric properties of instruments to measure quality of life (QOL) in clinical research on Japanese patients with breast cancer. The purpose of this systematic review is to find reliable and valid instruments available in Japan, and to summarize their characteristics.


Instruments available in Japan were found through a systematic search of the literature. Each instrument identified was evaluated for item development, reliability, validity, interpretability and utility.


Six questionnaires to measure health-related QOL (the QOL-ACD, the EORTC QLQ-C30, the EORTC QLQ-BR23, the FACT-B, the SF-36, the WHO/QOL-26) and five scales to quantify the psychological burden (the STAI, the POMS, the SDS, the HADS, the GHQ), for which reliability and validity have been documented, are available in Japanese. All instruments were developed in foreign countries except for the QOL-ACD. Two of the QOL questionnaires were specific to breast cancer (the EORTC QLQ-BR23, the FACT-B). Though the measurements can be interpreted in some manner, the meaning of change scores over time has been documented for only three instruments (the EORTC QLQ-C30, the FACT-B, and the GHQ).


The review provides grounds for designing and implementing quantitative research on QOL of breast cancer patients in Japan. Methodological challenges, however, continue, particularly for validating instruments with regard to various study populations of Japanese people and demonstrating the clinical importance of change scores.

Key words

Breast cancer Quality of life (QOL) Instruments Reliability Validity