Springer Nature is making SARS-CoV-2 and COVID-19 research free. View research | View latest news | Sign up for updates

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

Abstract

Purpose

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

Methods

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.

Results

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.

Conclusion

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.

This is a preview of subscription content, log in to check access.

References

  1. 1.

    Canadian Cancer Society’s Advisory Committee on Cancer Statistics (2014) Canadian cancer statistics 2014. Canadian Cancer Society, Toronto

  2. 2.

    Howlader N, Noone AM, Krapcho M, Garshell J, Miller D, Altekruse SF, et al (2015) SEER Cancer Statistics Review, 1975– 2012. National Cancer Institute. http://seer.cancer.gov/csr/1975_2012/. Accessed 16 Nov 2015

  3. 3.

    Scheid V, Buzdar AU, Smith TL, Hortobagyi GN (1986) Clinical course of breast cancer patients with osseous metastasis treated with combination chemotherapy. Cancer 58:2589–2593

  4. 4.

    Plunkett TA, Smith P, Rubens RD (2000) Risk of complications from bone metastases in breast cancer: implications for management. Eur J Cancer 36:476–482

  5. 5.

    Coleman RE, Smith P, Rubens RD (1998) Clinical course and prognostic factors following bone recurrence from breast cancer. Br J Cancer 77:336–340

  6. 6.

    Bouskill K, Kramer M (2016) The impact of cancer and quality of life among long-term survivors of breast cancer in Austria. Support Care Cancer. (Epub ahead of print)

  7. 7.

    Shin JA, El-Jawahri A, Parkes A, Schleicher SM, Knight HP, Temel JS (2016) Quality of Life, Mood, and Prognostic Understanding in Patients with Metastatic Breast Cancer. J Palliate Med. [Epub ahead of print]

  8. 8.

    Ecclestone C, Chow R, Pulenzas N, Zhang L, Leahey A, Hamer J et al (2016) Quality of life and symptom burden in patients with metastatic breast cancer. Support Care Cancer. [Epub ahead of print]

  9. 9.

    Vinokur AD, Threatt BA, Caplan RD, Zimmerman BL (1989) Physical and psychosocial functioning and adjustment to breast cancer. Long-term follow-up of a screening population. Cancer 63:394–405

  10. 10.

    Gotay CC, Muraoka MY (1998) Quality of life in long-term survivors of adult-onset cancers. J Natl Cancer Inst 90(6):656–667

  11. 11.

    Peerawong T, Phenwan T, Supanitwatthana S, Mahattamobon S, Kongkamol C (2016) Breast conserving therapy and quality of life in Thai females: a Mixed Methods Study. Asian Pac J Cancer Prev 17(6):2917–2921

  12. 12.

    Chow R, Pulenzas N, Zhang L, Ecclestone C, Leahey A, Hamer J et al (2016) Quality of life and symptom burden in patients with breast cancer treated with mastectomy and lumpectomy. Support Care Cancer 24:2191–2199

  13. 13.

    Hui D, Shamieh O, Paiva CE, Perez-Cruz PE, Kwon JH, Muckaden MA et al (2015) Minimal clinically important differences in the Edmonton symptom assessment scale in cancer patients: a prospective, multicenter study. Cancer 121(17):3027–3035

  14. 14.

    Richardson LA, Jones GW (2009) A review of the reliability and validity of the Edmonton symptom assessment system. Curr Oncol 16(1):55–79

  15. 15.

    Bruera E, Kuehn N, Miller MJ, Selmser P, Macmillan K (1991) The Edmonton Symptom Assessment System (ESAS): a simple method for the assessment of palliative care patients. J Palliat Care 7:6–9

  16. 16.

    Brady MJ, Cella DF, Bonomi AE, Tulsky DS, Lloyd SR, Deasy S et al (1997) Reliability and validity of the functional assessment of cancer therapy-breast quality-of-life instrument. J Clin Oncol 15(3):974–986

  17. 17.

    Cohen L, Hamer J, Helwig C, Fergus K, Kiss A, Mandel R et al (2016) Formal evaluation of PYNK: breast cancer program for young women – the patient perspective. Curr Oncol 23(2):e102–e108

  18. 18.

    Derks MG, de GlasNA, Bastiaannet E, de Craen AJ, Portielije JE, van de Velde CJ et al (2016) Physical Functioning in Older Patients With Breast Cancer: A Prospective Cohort Study in the TEAM trial. Oncologist (Epub ahead of print)

  19. 19.

    Leach CR, Bellizzi KM, Hurria A, Reeve BB (2016) Is it my cancer or am I just getting older?: impact of cancer on age-related health conditions of older cancer survivors. Cancer 112(12):1946–1953

  20. 20.

    Bellury L, Pett MA, Ellington L, Beck SL, Clark JC, Stein KD (2012) The effect of aging and cancer on the symptom experience and physical function of elderly breast cancer survivors. Cancer 118(24):6471–6178

  21. 21.

    Goedendorp MM, Andrykowski MA, Donovan KA, Jim HS, Phillips KM, Small BJ et al (2012) Prolonged impact of chemotherapy on fatigue in breast cancer survivors: a longitudinal comparison with radiotherapy-treated breast cancer survivors and non-cancer controls. Cancer 118(15):3833–3841

  22. 22.

    Ahles TA, Root JC, Ryan EL (2012) Cancer and cancer treatment-associated cognitive change: an update on the state of the science. J Clin Oncol 30(30):3675–3686

  23. 23.

    Jim HS, Phillips KM, Chait S, Faul LA, Popa MA, Lee YH et al (2012) Meta-analysis of cognitive functioning in breast cancer survivors previously treated with standard-dose chemotherapy. J Clin Oncol 30(29):3578–3587

  24. 24.

    Gordon LG, DiSipio T, Battistutta D, Yates P, Bashford J, Pyke C et al (2016) Cost-effectiveness of a pragmatic exercise intervention for women with breast cancer: results from a randomized, controlled trial. Psychooncology. [Epub ahead of print]

  25. 25.

    Leach HJ, Danyluk JM, Nishimura KC, Culos-Reed SN (2016) Benefits of 24 versus 12 weeks of exercise and wellness programming for women undergoing treatment for breast cancer. Support Care Cancer [Epub ahead of print]

  26. 26.

    Phillips SM, Lloyd GR, Awick EA, McAuley E (2016) Relationship between self-reported and objectively measured physical activity and subjective memory impairment in breast cancer survivors: role of self-efficacy, fatigue and distress. Psychooncology. [Epub ahead of print]

  27. 27.

    van Nes JG, Fontein DY, Hille EM, Voskuil DW, van Leeuwen FE, de Haes JM et al (2012) Quality of life in relation to tamoxifen or exemestane treatment in postmenopausal breast cancer patients: a Tamoxifen Exemestane Adjuvant Multinational (TEAM) Trial side study. Breast Cancer Res Treat 134(1):267–276

  28. 28.

    Chang CH, Chen SJ, Liu CY (2015) Adjuvant treatments of breast cancer increase the risk of depressive disorders: a population-based study. J Affect Disord 182:44–49

  29. 29.

    Kvale EA, Huang CS, Meneses KM, Demark-Wahnefried W, Bae S, Auzero CB et al (2016) Patient-centered support in the survivorship care transition: Outcomes from Patient-Owned Survivorship Care Plan Intervention. Cancer (Epub ahead of print). doi: 10.1002/cncr.30136

Download references

Acknowledgments

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.

Author information

Correspondence to Edward Chow.

Ethics declarations

Conflict of interest

There are no conflicts of interest.

Electronic supplementary materials

Below is the link to the electronic supplementary material.

ESM 1

(DOCX 28 kb)

ESM 2

(DOCX 556 kb)

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

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

Download citation

Keywords

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