Breast Cancer Research and Treatment

, Volume 170, Issue 2, pp 205–212 | Cite as

Health-related quality of life of Iranian breast cancer patients: a meta-analysis and systematic review

  • Salehoddin Bouya
  • Maryam koochakzai
  • Hosein Rafiemanesh
  • Abbas Balouchi
  • Safiyeh Taheri
  • Mahin Badakhsh
  • Mahnaz Didehvar



Quality of life is the most important psychological factor affecting breast cancer patients. This study aimed to examine the health related quality of life of breast cancer patients in Iran.


International (PubMed, Web of science, Scopus and Google scholar) and national (SID, Magiran) databases were searched for related studies to September 2017. The quality of the articles was evaluated using the Hoy tool.


Out of 232 initial studies, 18 studies performed on 2263 people were included in the final stage of the study. Based on the EORTC-QLQ-C30 and random effect method, the pooled mean score of quality of life in 1073 people was 57.88 (95% CI 48.26–67.41, I2 = 97.90%) and the pooled mean score of quality of life based on WHOQOL-BREF in 357 people was 66.79 (95% CI 45.96–87.62, I2 = 99.50%).


According to the results of the study, a moderate level of quality of life in women with breast cancer was indicated. Therefore, the use of multidimensional approaches can improve their quality of life.


Quality of life Breast Cancer Iran Systematic review 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflicts of interest.

Ethical approval

All procedures performed in the study described in this manuscript were in accordance with the ethical standards of the institutional and/or national research committee.


  1. 1.
    Torre LA, Siegel RL, Ward EM, Jemal A (2016) Global cancer incidence and mortality rates and trends—an update. Cancer Epidemiol Biomark Prev 25(1):16–27CrossRefGoogle Scholar
  2. 2.
    Jafari-Koshki T, Schmid VJ, Mahaki B (2014) Trends of breast cancer incidence in Iran during 2004-2008: a Bayesian space-time model. Asian Pac J Cancer Prev: APJCP 15(4):1557–1561CrossRefPubMedGoogle Scholar
  3. 3.
    Cancer IAfRo, Organization WH (2016) IARC handbooks of cancer prevention volume 15-breast cancer screening. Int Agency Res Cancer,Google Scholar
  4. 4.
    DeSantis CE, Bray F, Ferlay J, Lortet-Tieulent J, Anderson BO, Jemal A (2015) International variation in female breast cancer incidence and mortality rates. Cancer Epidemiol Biomark Prev 24(10):1495–1506CrossRefGoogle Scholar
  5. 5.
    DeSantis C, Ma J, Bryan L (2013) Jemal A (2014) Breast cancer statistics. CA Cancer J Clin 64(1):52–62CrossRefPubMedGoogle Scholar
  6. 6.
    Lamyian M, Heidarnia A, Ahmadi F, Faghihzadeh S, AguilarVafaie M (2008) Women’s prospect of breast cancer early detection behavior: a qualitative research. J Birjand Univ Med Sci 15(3):88–102Google Scholar
  7. 7.
    Park K (2002) Preventive and social medicine. M/s. Banarsidas bhanot publishers, Jabalpur (India)Google Scholar
  8. 8.
    Testa MA, Simonson DC (1996) Assessment of quality-of-life outcomes. N Engl J Med 334(13):835–840CrossRefPubMedGoogle Scholar
  9. 9.
    Park K (2007) Park’s textbook of preventive and social medicineGoogle Scholar
  10. 10.
    Barbotte E, Guillemin F, Chau N (2001) Prevalence of impairments, disabilities, handicaps and quality of life in the general population: a review of recent literature. Bull World Health Organ 79(11):1047–1055PubMedPubMedCentralGoogle Scholar
  11. 11.
    Alipour F, Sajadi H, Foruzan A, Biglarian A, Jalilian A (2008) Elderly quality of life in Tehran’s district two. Iran J Ageing 3(3):75–83Google Scholar
  12. 12.
    Kamali M, Arjmand HM, Ahangari M (2008) A Study of quality of life among older people with hypertension and low back pain. Salmand 3(7):26–32Google Scholar
  13. 13.
    Mousavi S, Asri M (2003) Educational requirements of patients with cancer during chemotherapy and radiotherapy for their self-care. JBUMS 5(1):17–20Google Scholar
  14. 14.
    Moher D, Liberati A, Tetzlaff J, Altman DG, Group P (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med 6(7):e1000097CrossRefGoogle Scholar
  15. 15.
    McGowan J, Sampson M, Salzwedel DM, Cogo E, Foerster V, Lefebvre C (2016) Press peer review of electronic search strategies: 2015 guideline statement. J Clin Epidemiol 75:40–46CrossRefPubMedGoogle Scholar
  16. 16.
    Hoy D, Brooks P, Woolf A, Blyth F, March L, Bain C, Baker P, Smith E, Buchbinder R (2012) Assessing risk of bias in prevalence studies: modification of an existing tool and evidence of interrater agreement. J Clin Epidemiol 65(9):934–939CrossRefPubMedGoogle Scholar
  17. 17.
    Jafari N, Farajzadegan Z, Zamani A, Bahrami F, Emami H, Loghmani A (2013) Spiritual well-being and quality of life in Iranian women with breast cancer undergoing radiation therapy. Support Care Cancer 21(5):1219–1225. CrossRefPubMedGoogle Scholar
  18. 18.
    Khalili N, Farajzadegan Z, Mokarian F, Bahrami F (2013) Coping strategies, quality of life and pain in women with breast cancer. Iranian J Nurs Midwifery Res 18(2):105Google Scholar
  19. 19.
    Moradi R, Roudi MA, Kiani MM, Rigi SAM, Mohammadi M, Keshvari M, Hosseini M (2017) Investigating the relationship between self-efficacy and quality of life in breast cancer patients receiving chemical therapy. Bali Med J 6(1):6–11. CrossRefGoogle Scholar
  20. 20.
    Musarezaie A, Ghasemi TM, Esfahani HN (2012) Investigation the quality of life and its relation with clinical and demographic characteristics in women with breast cancer under chemotherapy. Int J Prev Med 3(12):853–859CrossRefPubMedPubMedCentralGoogle Scholar
  21. 21.
    Sadoughi M, Mehrzad V, Mohammad Salehi Z (2017) The relationship between psychological capital and quality of life among patients with breast cancer. Razi J Med Sci 24(156):111–119Google Scholar
  22. 22.
    Kiaei M, Ferdosi M, Moradi R, Chelongar Q, Ahmadzadeh MS, Bahmanziari N (2016) Association between self-efficacy and quality of life in women with breast cancer undergoing chemotherapy. J Qazvin Univ Med Sci 20(2):58–65Google Scholar
  23. 23.
    HasanpourDehkordi A (2006) Factors affecting quality of life in cancer patients under chemotherapy in Tehran (2004). J Kermanshah Univ Med Sci 10 (2Google Scholar
  24. 24.
    Montazeri A, Vahdaninia M, Harirchi I, Ebrahimi M, Khaleghi F, Jarvandi S (2008) Quality of life in patients with breast cancer before and after diagnosis: an eighteen months follow-up study. BMC Cancer 8:330. CrossRefPubMedPubMedCentralGoogle Scholar
  25. 25.
    Najafi F, Nedjat S, Zendehdel K, Mirzania M, Montazeri A (2016) Self-reported versus proxy reported quality of life for breast cancer patients in the Islamic Republic of Iran. East Mediterr Health J 22(11):786–793CrossRefGoogle Scholar
  26. 26.
    Rohani C, Abedi HA, Omranipour R, Langius-Eklof A (2015) Health-related quality of life and the predictive role of sense of coherence, spirituality and religious coping in a sample of Iranian women with breast cancer: a prospective study with comparative design. Health Qual Life Outcomes 13:40. CrossRefPubMedPubMedCentralGoogle Scholar
  27. 27.
    Zamanian H, Eftekhar-Ardebili H, Eftekhar-Ardebili M, Shojaeizadeh D, Nedjat S, Taheri-Kharameh Z, Daryaafzoon M (2015) Religious coping and quality of life in women with breast cancer. Asian Pac J Cancer Prev APJCP 16(17):7721–7725CrossRefPubMedGoogle Scholar
  28. 28.
    Hatam N, Bastani P, Ahmadloo N, Kiadaliri AA (2012) Health related quality of life in breast cancer patients undergoing current chemotherapy protocols. J Kerman Univ Med Sci 19(1):49–58Google Scholar
  29. 29.
    Safaee A, Moghimi-Dehkordi B, Zeighami B, Tabatabaee H, Pourhoseingholi M (2008) Predictors of quality of life in breast cancer patients under chemotherapy. Indian J Cancer 45(3):107CrossRefPubMedGoogle Scholar
  30. 30.
    Bagheri M, Mazaheri M (2015) Body image and quality of life in female patients with breast cancer and healthy women. J Midwifery Reprod Health 3(1):285–292Google Scholar
  31. 31.
    Shandiz FH, Karimi FZ, Anbaran ZK, Abdollahi M, Rahimi N, Ghasemi M (2017) Investigating the quality of life and the related factors in iranian women with breast cancer. Asian Pac J Cancer Prev 18(8):2089–2092PubMedCentralGoogle Scholar
  32. 32.
    Hosseini SM (2014) Quality of life, pain and treatment acceptance in women with breast cancer in Chaharamahal and Bakhtiari. Iran Q J Breast Dis 6(4):52–59Google Scholar
  33. 33.
    Monfared A, Pakseresht S, Ghanbari Khanghah A, Atrkar-Roshan Z (2013) Health-Related Quality of Life and its related factors among women with breast cancer. J Holist Nurs Midwifery 23(2):52–62Google Scholar
  34. 34.
    Ayatollahi H (2013) Quality of life in breast cancer patients: study in the Omid cancer research center– Urmia. Iran Q J Breast Dis 5(4):35–43Google Scholar
  35. 35.
    Montazeri A, Goshtasebi A, Vahdaninia M, Gandek B (2005) The short form health survey (SF-36): translation and validation study of the Iranian version. Q Life Res 14(3):875–882CrossRefGoogle Scholar
  36. 36.
    Nejat S, Montazeri A, Holakouie Naieni K, Mohammad K, Majdzadeh S (2006) The world health organization quality of Life (WHOQOL-BREF) questionnaire: translation and validation study of the Iranian version. J Sch Publ Health Inst Publ Health Res 4(4):1–12Google Scholar
  37. 37.
    Montazeri A, Harirchi I, Vahdani M, Khaleghi F, Jarvandi S, Ebrahimi M, Haji-Mahmoodi M (1999) The European organization for research and treatment of cancer quality of life questionnaire (EORTC QLQ-C30): translation and validation study of the Iranian version. Support Care Cancer 7(6):400–406CrossRefPubMedGoogle Scholar
  38. 38.
    Rafiei N, Sharifian Sani M, Rafiey H, Behnampour N, Foroozesh K (2014) Reliability and Validity of Persian Version of. J Mazandaran Univ Med Sci 24(116):75–83Google Scholar
  39. 39.
    Saleha S, Shakeel A, Shumaila E, Shazia R, Rashid R, Ibrahim M (2012) An assessment of quality of life in breast cancer patients using EORTC QLQ C30/+ Br 23 questionnaire. Iran J Cancer Prev 3(2):98–104Google Scholar
  40. 40.
    Almutairi KM, Mansour EA, Vinluan JM (2016) A cross-sectional assessment of quality of life of breast cancer patients in Saudi Arabia. Publ Health 136:117–125. CrossRefGoogle Scholar
  41. 41.
    Ahn S, Park B, Noh D, Nam S, Lee E, Lee M, Kim S, Lee K, Park S, Yun Y (2006) Health-related quality of life in disease-free survivors of breast cancer with the general population. Ann Oncol 18(1):173–182CrossRefPubMedGoogle Scholar
  42. 42.
    Hopwood P, Haviland J, Mills J, Sumo G, Bliss JM (2007) The impact of age and clinical factors on quality of life in early breast cancer: an analysis of 2208 women recruited to the UK START Trial (standardisation of breast radiotherapy trial). The Breast 16(3):241–251CrossRefPubMedGoogle Scholar
  43. 43.
    Waldmann A, Pritzkuleit R, Raspe H, Katalinic A (2007) The OVIS study: health related quality of life measured by the EORTC QLQ-C30 and-BR23 in German female patients with breast cancer from Schleswig-Holstein. Q Life Res 16(5):767–776CrossRefGoogle Scholar
  44. 44.
    Rabin EG, Heldt E, Hirakata VN, Fleck MP (2008) Quality of life predictors in breast cancer women. Eur J Oncol Nurs 12(1):53–57CrossRefPubMedGoogle Scholar
  45. 45.
    Purkayastha D, Venkateswaran C, Nayar K, Unnikrishnan U (2017) Prevalence of depression in breast cancer patients and its association with their quality of life: a cross-sectional observational study. Indian J Palliat Care 23(3):268CrossRefPubMedPubMedCentralGoogle Scholar
  46. 46.
    Sammarco A (2001) Perceived social support, uncertainty, and quality of life of younger breast cancer survivors. Cancer Nurs 24(3):212–219CrossRefPubMedGoogle Scholar
  47. 47.
    Avis NE, Crawford S, Manuel J (2005) Quality of life among younger women with breast cancer. J Clin Oncol 23(15):3322–3330CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Clinical Immunology Research CenterAli-ebne Abitaleb Hospital, Zahedan University of Medical SciencesZahedanIran
  2. 2.Department of Midwifery, School of Nursing and MidwiferyZabol University of Medical ScienceZabolIran
  3. 3.Student Research Committee, School of Public HealthShahid Beheshti University of Medical SciencesTehranIran
  4. 4.Department of Epidemiology, School of Public HealthShahid Beheshti University of Medical SciencesTehranIran
  5. 5.Zabol University of Medical SciencesZabolIran
  6. 6.Student Research Committee, Nursing and Midwifery SchoolUniversity of Medical SciencesTehranIran
  7. 7.Midwifery Department, School of Nursing and MidwiferyIranshahr University of Medical SciencesIranshahrIran

Personalised recommendations