Health-related quality of life of breast cancer patients in the Eastern Mediterranean region: a systematic review and meta-analysis

  • Seyed-Mehdi Hashemi
  • Abbas Balouchi
  • Adhra Al-Mawali
  • Hosein Rafiemanesh
  • Khadije Rezaie-KeikhaieEmail author
  • Salehoddin Bouya
  • Behroz Dehghan
  • Mansoureh Ashghali Farahani



Breast cancer is the most common type of cancer in women around the world, and this applies to the Middle East as well. The goal of all medical care and treatment is to improve the quality of life (QoL) of patients. Accordingly, the present study aimed at evaluating the QoL of patients with breast cancer in the Middle East region.


In this meta-analysis, three electronic databases (PubMed, Web of Science, and Scopus) were searched from inception until August 2018. The hoy et tool was used to evaluate the quality of the articles included in the meta-analysis. The search, screening, quality evaluation, and data extraction were carried out by two of the researchers.


Thirty-six studies conducted on 8347 Middle Eastern women with breast cancer entered the final stage. QoL was assessed by the European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire in 20 studies, with 6034 patients. The mean of the reported QoL was between 31.1 and 75.6. Based on the results of the random effect method, the overall mean of the QoL was 60.5 (95% confidence interval 56.0, 65.0; I2 = 99.0%). In six studies performed on 1053 individuals, QoL was classified as good, moderate, or poor. Less than one-third of patients (21%) had a good QoL.


Since less than one-third of patients had a good QoL, it seems necessary to design and implement an integrated and multidimensional educational program to improve QoL of patients with breast cancer.


Quality of Life Breast neoplasms Middle east Systematic review 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflicts of interest.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors. Hence, it does not need any human consent.


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© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Seyed-Mehdi Hashemi
    • 1
  • Abbas Balouchi
    • 2
    • 3
  • Adhra Al-Mawali
    • 4
  • Hosein Rafiemanesh
    • 5
  • Khadije Rezaie-Keikhaie
    • 6
    Email author return OK on get
  • Salehoddin Bouya
    • 7
  • Behroz Dehghan
    • 8
  • Mansoureh Ashghali Farahani
    • 9
  1. 1.Clinical Immunology Research Center, Department of Internal Medicine, School of MedicineZahedan University of Medical SciencesZahedanIran
  2. 2.Nursing DepartmentZabol University of Medical SciencesZabolIran
  3. 3.Student Research Committee, Nursing and Midwifery SchoolIran University of Medical SciencesTehranIran
  4. 4.Director of Centre of Studies and ResearchMinistry of HealthMuscatOman
  5. 5.Student Research Committee, Department of Epidemiology, School of Public Health and SafetyShahid Beheshti University of Medical SciencesTehranIran
  6. 6.Department of Obstetrics and GynecologyZabol University of Medical SciencesZabolIran
  7. 7.Clinical Immunology Research Center Ali-ebne Abitaleb HospitalZahedan University of Medical SciencesZahedanIran
  8. 8.Zahedan University of Medical SciencesZahedanIran
  9. 9.Nursing Care Research Center and School of Nursing and MidwiferyIran University of Medical SciencesTehranIran

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