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Long-term trajectory of postoperative health-related quality of life in young breast cancer patients: a 15-year follow-up study

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Abstract

Purpose

Breast cancer (BC) patients often experience various long-term sequelae due to aggressive treatment. We analyzed and illustrated long-term trajectory during different phases of treatment and survivorship.

Methods

Data were obtained from a cohort of 298 BC patients diagnosed between 2004 and 2006 and were followed up until 2020. We measured HRQoL using EORTC QLQ-C30, QLQ-BR23, and EuroQoL-5D questionnaires and conducted eight assessments right after initial diagnosis, during treatment, post-treatment, and during survivorship phases. Linear mixed model was used to assess changes in HRQoL. Overall HRQoL measured by EQ-5D index of long-term BC survivors were further compared with that of the age-matched general population.

Results

Of 298 participants, 246 women survived and 124 participated in the long-term follow-up survey (LTFU). Overall, HRQoL functions deteriorated during treatment but gradually improved between 1- and 3-year post-diagnosis and stabilized over LTFU measure. Significant recovery was observed in physical, role, emotional, social functions, and future perspectives (p < 0.05). Treatment-related acute symptoms were reported in the first year but diminished afterward, and treatment-related financial difficulties lessened. At LTFU, BC survivors reported a high level of insomnia, fatigue, and pain and appeared to have poorer overall HRQoL than the general population (mean difference, EQ-5D index: 0.073, p < 0.001).

Conclusions

Through 15-year survivorship, BC survivors showed improvement in many aspects of HRQoL. However, some inferior aspects remain relevant for long-term survivors. Ongoing supportive programs concentrating on pain management, persistent cancer-related fatigue, and sleeping problems might aid enhance their HRQoL.

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Funding

This work was supported by the National Cancer Center of Korea (grant number NCC-04101502 and NCC-1911271) and the National Research Foundation of Korea (funded by the Korea Ministry of Science and ICT, grant number 2020R1A2C1A01011584). The funder had no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the article for publication.

Author information

Author notes

  1. Hyunsoon Cho and Yoon Jung Chang contributed equally to this work as corresponding authors.

Authors and Affiliations

  1. Department of Cancer Control and Population Health, National Cancer Center Graduate School of Cancer Science and Policy, National Cancer Center, 10408, Goyang, Republic of Korea

    Thi Xuan Mai Tran, Yoon Jung Chang & Hyunsoon Cho

  2. Center for Breast Cancer, Research Institute and Hospital, National Cancer Center, Goyang, 10408, Republic of Korea

    So-Youn Jung, Eun-Gyeong Lee & Eunsook Lee

  3. Division of Cancer Control and Policy, National Cancer Control Institute, National Cancer Center, Goyang, 10408, Republic of Korea

    Heeyoun Cho & Yoon Jung Chang

  4. Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, Seoul, 06351, Republic of Korea

    Juhee Cho

  5. Department of Cancer Biomedical Science, National Cancer Center Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, 10408, Republic of Korea

    Eunsook Lee

  6. Division of Cancer Registration and Surveillance, National Cancer Control Institute, National Cancer Center, Goyang, 10408, Republic of Korea

    Hyunsoon Cho

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  1. Thi Xuan Mai Tran
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Contributions

Thi Xuan Mai Tran: conceptualization, methodology, investigation, formal analysis, data curation, writing — original draft; So Youn Jung: conceptualization, validation, data curation, writing — review and editing; Eun-Gyeong Lee: data curation, writing — review and editing; Heeyoun Cho: project administration, writing — review and editing; Juhee Cho: conceptualization, methodology, investigation, validation, writing — review and editing; Eunsook Lee: conceptualization, methodology, investigation, supervision, validation, writing — review and editing; Yoon Jung Chang: conceptualization, methodology, investigation, supervision, formal analysis, data curation, writing — review and editing; Hyunsoon Cho: conceptualization, methodology, investigation, supervision, formal analysis, data curation, writing — original draft.

Corresponding authors

Correspondence to Yoon Jung Chang or Hyunsoon Cho.

Ethics declarations

Ethics approval and consent to participate

This study was approved by the Institutional Review Board of NCC (NCCNCS-04–034 and NCC2019-0281). All patients provided written informed consent before their participation.

Conflict of interest

The authors declare no competing interests.

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Tran, T.X.M., Jung, SY., Lee, EG. et al. Long-term trajectory of postoperative health-related quality of life in young breast cancer patients: a 15-year follow-up study. J Cancer Surviv 17, 1416–1426 (2023). https://doi.org/10.1007/s11764-022-01165-4

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  • DOI: https://doi.org/10.1007/s11764-022-01165-4

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