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Quality of life (QOL) and symptom burden (SB) in patients with breast cancer



The purpose of this study was to determine the quality of life (QOL) and symptom burden (SB) among breast cancer patients.


Patients with DCIS, early stage, locally advanced, or metastatic breast cancer completed the Edmonton Symptom Assessment System (ESAS) and the Functional Assessment of Cancer Therapy for Breast Cancer (FACT-B). Patients were divided into subsequent cohorts based on their last day of treatment, age at enrollment, radiation, chemotherapy, and hormone therapy.


A total of 1513 patients were enrolled. Metastatic patients had a lower QOL and greatest SB compared to all other patient groups. Patients ≤50 years old with early stage or locally advanced breast cancer had a lower QOL and greater SB for fatigue, depression, and anxiety compared to all other age cohorts. Patients with early stage breast cancer who received chemotherapy had a lower QOL and greater SB. Patients taking selective estrogen receptor modulator (SERM) had greater SB for depression and lower QOL compared to those not on SERM. Patients 2–10 years post-treatment had a lower QOL compared to patients ≥10 years post-treatment.


Patients ≤50 years old, 2–10 years post-treatment, treated with chemotherapy or SERM had increased SB and decreased QOL. Individualized interventions and programs can be developed to tailor to physical, educational, and psychosocial needs identified across the breast cancer continuum.

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We thank the generous support of Bratty Family Fund, Michael and Karyn Goldstein Cancer Research Fund, Joey and Mary Furfari Cancer Research Fund, Pulenzas Cancer Research Fund, Joseph and Silvana Melara Cancer Research Fund, and Ofelia Cancer Research Fund.

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Correspondence to Edward Chow.

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Hamer, J., McDonald, R., Zhang, L. et al. Quality of life (QOL) and symptom burden (SB) in patients with breast cancer. Support Care Cancer 25, 409–419 (2017). https://doi.org/10.1007/s00520-016-3417-6

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  • Quality of life
  • Symptom burden
  • Breast cancer
  • ESAS
  • FACT-B