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Health related quality of life in different states of breast cancer

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The aim of this study was to describe the health related quality of life (HRQoL) in different breast cancer disease states using preference-based measures.

Material and Methods

A total of 361 consecutive breast cancer patients attending the breast cancer outpatient clinic at Karolinska University hospital Solna for outpatient visits between April and May 2005 were included in the study. The EQ-5D self classifier and a direct Time Trade Off (TTO) question were used to estimate the HRQoL in different breast cancer disease states.


Patients in their first year after a primary breast cancer had a mean EQ-5D index value of 0.696 (95% confidence interval (CI): 0.634–0.747)). Patients in their first year after a recurrence had a mean EQ-5D index value of 0.779 (CI: 0.700–0.849). Patients who had not had a primary breast cancer diagnosis or a recurrence during the previous year had a mean EQ-5D index value of 0.779 (CI: 0.745–0.811). Patients with metastatic disease reported the lowest HRQoL values, and had a mean EQ-5D index value of 0.685 (CI: 0.620–0.735). The main driver behind the reduction in HRQoL was pain and discomfort as well as anxiety and depression. TTO values were higher for all diseases states compared to the EQ-5D index values.


This study shows that breast cancer is associated with a reduction in HRQoL. This effect is most pronounced for patients with metastatic disease.

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  1. First year after primary breast cancer.

  2. First year after recurrence.

  3. Second and following years after primary breast cancer or recurrence.

  4. Metastatic disease.


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We would like to thank all the patients that agreed to participate in this study. We would also like to thank the nurses and doctors at Radiumhemmet, Karolinska Sjukhuset, Solna, as well as research nurse Ulrika Larsson, for their help and support in administering the questionnaires to the patients. We are also grateful to Johan Almbrandt at Stockholm Oncology Centre for his help in gathering patient specific disease data needed in order to stratify patients into different disease states. Support in questionnaire design by Ulla Wilking is also acknowledged. We want to thank the external reviewers, who gave many helpful comments and suggestions which helped to improve this study. This study was funded by Astra Zeneca. The funding sources played no role in the design, methods, data collection, analysis or interpretation of the results of the study. Publication of this study was not contingent on the sponsor’s approval.

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Correspondence to Mathias Lidgren.

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Lidgren, M., Wilking, N., Jönsson, B. et al. Health related quality of life in different states of breast cancer. Qual Life Res 16, 1073–1081 (2007).

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