Breast Cancer Research and Treatment

, Volume 109, Issue 2, pp 379–387 | Cite as

Health-related quality of life before and after a breast cancer diagnosis

  • Amy Trentham-Dietz
  • Brian L. Sprague
  • Ronald Klein
  • Barbara E. K. Klein
  • Karen J. Cruickshanks
  • Dennis G. Fryback
  • John M. Hampton
Epidemiology

Abstract

While many reports describe health-related quality of life (QOL) among breast cancer survivors, few compare QOL before and after diagnosis and whether changes in QOL substantially differ from changes experienced by all women during aging. QOL was examined in a cohort of female residents of Beaver Dam, Wisconsin, aged 43–86 years at the time of a 1988–1990 baseline examination (N = 2,762; 83% of eligible). Participants were re-contacted four times through 2002 to ascertain QOL using the 36-item Short Form Health Survey (SF-36). QOL data for 114 incident breast cancer cases identified by data linkage with the statewide cancer registry were compared with data for 2,527 women without breast cancer. Women with breast cancer averaged 4.5 (95% CI: 1.6, 7.3) points lower than control women on the SF-36 Physical Component Summary (PCS) scale, regardless of time since diagnosis (up to 13 years). Women with breast cancer also reported lower scores on the SF-36 Mental Component Summary (MCS) scale within two years after diagnosis, but not at more distant times. In longitudinal analyses, 26 women who completed the SF-36 before and after breast cancer diagnosis experienced larger declines than age-matched controls in seven of the eight SF-36 health domains (all but role-emotional) and reported relative declines of −7.0 (95% CI: −11.5, −2.6) and −2.9 (95% CI: −6.3, 0.6) on the PCS and MCS scales, respectively. These results suggest that breast cancer survivors experience relative declines in health-related QOL across a broad spectrum of domains, even many years after diagnosis.

Keywords

Breast cancer Epidemiology Functional health status Long-term cancer survivors Prospective Quality of life SF-36 

References

  1. 1.
    Ries L, Melbert D, Krapcho M et al (2007) SEER Cancer Statistics Review, 1975–2004. National Cancer Institute, Bethesda, MD, http://seer.cancer.gov/csr/1975_2004/, based on November 2006 SEER data submission, posted to the SEER web siteGoogle Scholar
  2. 2.
    Brenner H (2002) Long-term survival rates of cancer patients achieved by the end of the 20th century: a period analysis. Lancet 360(9340):1131–1135PubMedCrossRefGoogle Scholar
  3. 3.
    Goodwin PJ, Black JT, Bordeleau LJ et al (2003) Health-related quality-of-life measurement in randomized clinical trials in breast cancer—taking stock. J Natl Cancer Inst 95(4):263–281PubMedCrossRefGoogle Scholar
  4. 4.
    Costantino J (2002) The impact of hormonal treatments on quality of life of patients with metastatic breast cancer. Clin Ther 24(Suppl C):C26–42PubMedCrossRefGoogle Scholar
  5. 5.
    Land SR, Wickerham DL, Costantino JP et al (2006) Patient-reported symptoms and quality of life during treatment with tamoxifen or raloxifene for breast cancer prevention: the NSABP Study of Tamoxifen and Raloxifene (STAR) P-2 trial. JAMA 295(23):2742–2751PubMedCrossRefGoogle Scholar
  6. 6.
    Poole CJ, Earl HM, Hiller L et al (2006) Epirubicin and cyclophosphamide, methotrexate, and fluorouracil as adjuvant therapy for early breast cancer. N Engl J Med 355(18):1851–1862PubMedCrossRefGoogle Scholar
  7. 7.
    Martin M, Pienkowski T, Mackey J et al (2005) Adjuvant docetaxel for node-positive breast cancer. N Engl J Med 352(22):2302–2313PubMedCrossRefGoogle Scholar
  8. 8.
    Li BD, Brown WA, Ampil FL et al (2000) Patient compliance is critical for equivalent clinical outcomes for breast cancer treated by breast-conservation therapy. Ann Surg 231(6):883–889PubMedCrossRefGoogle Scholar
  9. 9.
    Mandelblatt J, Figueiredo M, Cullen J (2003) Outcomes and quality of life following breast cancer treatment in older women: When, why, how much, and what do women want? Health Qual Life Outcomes 1(1):45PubMedCrossRefGoogle Scholar
  10. 10.
    Mols F, Vingerhoets AJ, Coebergh JW et al (2005) Quality of life among long-term breast cancer survivors: a systematic review. Eur J Cancer 41(17):2613–2619PubMedCrossRefGoogle Scholar
  11. 11.
    Ware J Jr, Snow K, Kosinski M et al (1993) SF-36 health survey manual and interpretation guide. The Health Institute, New England Medical Center, Boston, MAGoogle Scholar
  12. 12.
    Shimozuma K, Sonoo H, Ichihara K (1995) Analysis of the factors influencing the quality of life of patients with advanced or recurrent breast cancer. Surg Today 25(10):874–882PubMedCrossRefGoogle Scholar
  13. 13.
    Engel J, Kerr J, Schlesinger-Raab A et al (2003) Predictors of quality of life of breast cancer patients. Acta Oncol 42(7):710–718PubMedCrossRefGoogle Scholar
  14. 14.
    Satariano WA, Ragheb NE, Buck KA et al (1989) Aging and breast cancer: a case–control comparison of instrumental functioning. J Aging Health 1:209–233CrossRefGoogle Scholar
  15. 15.
    Bloom JR, Stewart SL, Chang S et al (2004) Then and now: quality of life of young breast cancer survivors. Psychooncology 13(3):147–160PubMedCrossRefGoogle Scholar
  16. 16.
    Ganz PA, Guadagnoli E, Landrum MB et al (2003) Breast cancer in older women: quality of life and psychosocial adjustment in the 15 months after diagnosis. J Clin Oncol 21(21):4027–4033PubMedCrossRefGoogle Scholar
  17. 17.
    Vinokur AD, Threatt BA, Caplan RD et al (1989) Physical and psychosocial functioning and adjustment to breast cancer. Long-term follow-up of a screening population. Cancer 63(2):394–405PubMedCrossRefGoogle Scholar
  18. 18.
    Vinokur AD, Threatt BA, Vinokur-Kaplan D et al (1990) The process of recovery from breast cancer for younger and older patients. Changes during the first year. Cancer 65(5):1242–1254PubMedCrossRefGoogle Scholar
  19. 19.
    Satariano WA, Ragland DR (1996) Upper-body strength and breast cancer: a comparison of the effects of age and disease. J Gerontol A Biol Sci Med Sci 51(5):M215–219PubMedGoogle Scholar
  20. 20.
    Broeckel JA, Jacobsen PB, Balducci L et al (2000) Quality of life after adjuvant chemotherapy for breast cancer. Breast Cancer Res Treat 62(2):141–150PubMedCrossRefGoogle Scholar
  21. 21.
    Michael YL, Kawachi I, Berkman LF et al (2000) The persistent impact of breast carcinoma on functional health status: prospective evidence from the Nurses’ Health Study. Cancer 89(11):2176–2186PubMedCrossRefGoogle Scholar
  22. 22.
    Kroenke CH, Rosner B, Chen WY et al (2004) Functional impact of breast cancer by age at diagnosis. J Clin Oncol 22(10):1849–1856PubMedCrossRefGoogle Scholar
  23. 23.
    Klein BE, Klein R, Lee KE et al (2006) Statin use and incident nuclear cataract. JAMA 295(23):2752–2758PubMedCrossRefGoogle Scholar
  24. 24.
    Klein R, Klein BE, Linton KL et al (1991) The Beaver Dam Eye Study: visual acuity. Ophthalmology 98(8):1310–1315PubMedGoogle Scholar
  25. 25.
    Cruickshanks KJ, Tweed TS, Wiley TL et al (2003) The 5-year incidence and progression of hearing loss: the epidemiology of hearing loss study. Arch Otolaryngol Head Neck Surg 129(10):1041–1046PubMedCrossRefGoogle Scholar
  26. 26.
    Cruickshanks KJ, Wiley TL, Tweed TS et al (1998) Prevalence of hearing loss in older adults in Beaver Dam, Wisconsin. The Epidemiology of Hearing Loss Study. Am J Epidemiol 148(9):879–886PubMedGoogle Scholar
  27. 27.
    Fryback DG, Dasbach EJ, Klein R et al (1993) The Beaver Dam Health Outcomes Study: initial catalog of health-state quality factors. Med Decis Making 13(2):89–102PubMedCrossRefGoogle Scholar
  28. 28.
    Shankar A, Klein BE, Klein R (2004) Relationship between white blood cell count and incident hypertension. Am J Hypertens 17(3):233–239PubMedCrossRefGoogle Scholar
  29. 29.
    Klein R, Klein BE, Lee KE (1996) Changes in visual acuity in a population. The Beaver Dam Eye Study. Ophthalmology 103(8):1169–1178PubMedGoogle Scholar
  30. 30.
    Klein R, Klein BE, Lee KE et al (2001) Changes in visual acuity in a population over a 10-year period: The Beaver Dam Eye Study. Ophthalmology 108(10):1757–1766PubMedCrossRefGoogle Scholar
  31. 31.
    Ware J Jr, Kosinski M, Keller S (1994) SF-36 physical and mental health summary scales: a user’s manual. Health Assessment Lab, New England Medical Center, Boston, MAGoogle Scholar
  32. 32.
    Palta M (2003) Quantitative methods in population health; extensions of ordinary regression. John Wiley & Sons, Inc, Hoboken, NJGoogle Scholar
  33. 33.
    Ganz PA, Desmond KA, Leedham B et al (2002) Quality of life in long-term, disease-free survivors of breast cancer: a follow-up study. J Natl Cancer Inst 94(1):39–49PubMedGoogle Scholar
  34. 34.
    Ganz PA, Greendale GA, Petersen L et al (2003) Breast cancer in younger women: reproductive and late health effects of treatment. J Clin Oncol 21(22):4184–4193PubMedCrossRefGoogle Scholar
  35. 35.
    Nekhlyudov L, Kroenke CH, Jung I et al (2006) Prospective changes in quality of life after ductal carcinoma-in-situ: results from the Nurses’ Health Study. J Clin Oncol 24(18):2822–2827PubMedCrossRefGoogle Scholar
  36. 36.
    Shimozuma K, Ganz PA, Petersen L et al (1999) Quality of life in the first year after breast cancer surgery: rehabilitation needs and patterns of recovery. Breast Cancer Res Treat 56(1):45–57PubMedCrossRefGoogle Scholar
  37. 37.
    Vacek PM, Winstead-Fry P, Secker-Walker RH et al (2003) Factors influencing quality of life in breast cancer survivors. Qual Life Res 12(5):527–537PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2007

Authors and Affiliations

  • Amy Trentham-Dietz
    • 1
    • 2
  • Brian L. Sprague
    • 1
    • 2
  • Ronald Klein
    • 3
  • Barbara E. K. Klein
    • 3
  • Karen J. Cruickshanks
    • 1
    • 3
  • Dennis G. Fryback
    • 1
    • 4
  • John M. Hampton
    • 2
  1. 1.Department of Population Health SciencesUniversity of WisconsinMadisonUSA
  2. 2.University of Wisconsin Paul P. Carbone Comprehensive Cancer CenterMadisonUSA
  3. 3.Department of Ophthalmology and Visual SciencesUniversity of WisconsinMadisonUSA
  4. 4.Department of Industrial EngineeringUniversity of WisconsinMadisonUSA

Personalised recommendations