Breast Cancer Research and Treatment

, Volume 62, Issue 2, pp 141–150

Quality of life after adjuvant chemotherapy for breast cancer

  • Jo Ann Broeckel
  • Paul B. Jacobsen
  • Lodovico Balducci
  • John Horton
  • Gary H. Lyman


Purpose.To evaluate the quality of life of breast cancer patients previously treated with adjuvant chemotherapy.

Method.Registry data were used to recruit a sample of breast cancer patients (N = 61; mean age = 51.6 years) with no current evidence of disease who had completed adjuvant chemotherapy between 3 and 36 months earlier (average = 15.87 months). In addition, a peer nomination procedure was used to recruit an age-matched comparison group of women with no history of cancer (N = 59; mean age = 51.5 years). Both groups were mailed a survey to complete that included the Medical Outcomes Study Short Form 36 (SF-36) and the Center for Epidemiologic Studies Depression Scale (CES-D). These data were used to test the hypothesis that breast cancer patients previously treated with adjuvant chemotherapy experience impaired quality of life relative to their peers and to identify demographic and medical factors associated with individual differences in patient quality of life.

Results.Consistent with predictions, the postchemotherapy group scored poorer than the noncancer comparison group on the CES-D and on six of the eight subscales as well as the physical component summary scale of the SF-36 (p < 0.05). With regard to individual differences in patient quality of life, younger age and unmarried status were positively related to poorer mental well-being and greater depressive symptomatology (p < 0.05). Time since cancer diagnosis and chemotherapy completion were also positively related to greater depressive symptomatology (p < 0.05). In contrast, none of the demographic or medical variables assessed were related to physical well-being (p > 0.05).

Conclusions.Breast cancer patients appear to experience problems in multiple quality of life domains following the completion of adjuvant chemotherapy treatment. Demographic and medical characteristics explain individual differences in mental but not physical aspects of patient quality of life. These findings demonstrate the need for interventions to improve the quality of life in breast cancer patients previously treated with adjuvant chemotherapy.

adjuvant chemotherapy breast cancer quality of life 


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  1. 1.
    American Cancer Society: Cancer Facts and Figures. American Cancer Society, Atlanta, GA, 1999Google Scholar
  2. 2.
    Early Breast Cancer Trialists' Collaborative Group: Systemic treatment of early breast cancer by hormonal, cytotoxic, or immune therapy: 133 randomized trials involving 31,000 recurrences and 24,000 deaths among 75,000 women. Lancet 339: 1–15, 1992Google Scholar
  3. 3.
    Hurny C, Bernhard J, Coates AS, Castiglione-Gertsch M, Peterson HF, Gelber RD, Forbes JF, Rudenstam CM, Simoncini E, Crivellari D, Goldhirsch A, Senn HJ: Impact of adjuvant therapy on quality of life in women with node-positive operable breast cancer. Lancet 347: 1279–1284, 1996PubMedGoogle Scholar
  4. 4.
    Greene D, Nail LM, Fieler VK, Dudgeon D, Jones LS: A comparison of patient-reported side effects among three chemotherapy regimens for breast cancer. Cancer Prac 22: 57–62, 1994Google Scholar
  5. 5.
    Beisecker AE, Cook MR, Ashworth J, Hayes J, Brecheisen M, Helmig L, Hyland S, Selenke D: Side effects of adjuvant chemotherapy: perceptions of node-negative breast cancer patients. Psycho-Oncology 6: 85–93, 1997PubMedGoogle Scholar
  6. 6.
    Maguire GP, Tait A, Brooke M, Thomas C, Howat JM, Sellwood RA, Bush H: Psychiatric morbidity and physical toxicity associated with adjuvant chemotherapy after mastectomy. Br Med J 281: 1179–1180, 1988Google Scholar
  7. 7.
    Ferrell BR, Grant M, Funk B, Garcia N, Otis-Green S, Schaffner MLJ: Quality of life in breast cancer. Cancer Prac 4: 331–340, 1996Google Scholar
  8. 8.
    Dow KH, Ferrell BR, Leigh S, Ly J, Gulasekaram P: An evaluation of the quality of life among long-term survivors of breast cancer. Breast Cancer Res Treat 39: 261–273, 1996PubMedGoogle Scholar
  9. 9.
    Ganz PA, Coscarelli A, Fred C, Kahn B, Polinsky ML, Petersen L: Breast cancer survivors: psychosocial concerns and quality of life. Breast Cancer Res Treat 38: 183–199, 1996PubMedGoogle Scholar
  10. 10.
    Ganz PA, Rowland JH, Desmond K, Meyerowitz BE, Wyatt GE: Life after breast cancer: understanding women's healthrelated quality of life and sexual functioning. J Clin Oncol 16: 501–514, 1998PubMedGoogle Scholar
  11. 11.
    Knobf MT: Physical and psychologic distress associated with adjuvant chemotherapy in women with breast cancer. J Clin Oncol 4: 678–684, 1986PubMedGoogle Scholar
  12. 12.
    McCorkle R, Young K: Developing a symptom distress scale. Cancer Nurs 1: 373–378, 1978PubMedGoogle Scholar
  13. 13.
    Spitzer RL, Endicott J, Fleiss JL, Cohen J: The psychiatric status schedule. Arch Gen Psychiatry 23: 41–55, 1970PubMedGoogle Scholar
  14. 14.
    Berglund G, Bolund C, Fornander T, Rutqvist LE, Sjoden PO: Late effects of adjuvant chemotherapy and postoperative radiotherapy on quality of life among breast cancer patients. Eur J Cancer 27: 1075–1081, 1991PubMedGoogle Scholar
  15. 15.
    van Dam FSAM, Schagen SB, Muller MJ, Boogerd W, Wall E, Fortuyn D, Rodenhuis S: Impairment of cognitive function in women receiving adjuvant treatment for high-risk breast cancer: high-dose versus standard-dose chemotherapy. J Natl Cancer Inst 90: 210–218, 1998PubMedGoogle Scholar
  16. 16.
    Aaronson NK, Ahmedzi S, Bergman B, Bullinger M, Cull A: The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst 85: 365–376, 1993PubMedGoogle Scholar
  17. 17.
    Ibbotson T, Maguire P, Selby P, Priestman T, Wallace L: Screening for anxiety and depression in cancer patients: the effects of disease and treatment. Eur J Cancer 30A: 37–40, 1994PubMedGoogle Scholar
  18. 18.
    Schagen SB, van Dam FS, Muller MJ, Boogerd W, Lindeboom J, Bruning PF: Cognitive deficits after postoperative adjuvant chemotherapy for breast carcinoma. Cancer 85: 640–650, 1999PubMedGoogle Scholar
  19. 19.
    Lindley C, Vasa S, Sawyer WT, Winer EP: Quality of life and preferences for treatment following systemic adjuvant therapy for early-stage breast cancer. J Clin Oncol 16: 1380–1387, 1998PubMedGoogle Scholar
  20. 20.
    Schipper H, Clinch J, McMurray A, Levitt M: Measuring the quality of life of cancer patients: the Functional Living Index-Cancer: development and validation. J Clin Oncol 2: 472–473, 1984PubMedGoogle Scholar
  21. 21.
    Ware JE: SF-36 Health Survey: Manual and Interpretation Guide. The Health Institute, New England Medical Center, Boston, MA, 1993Google Scholar
  22. 22.
    Radloff LS: The CES-D scale: a self-report depression scale for research in the general population. Appl Psychol Measure 1: 385–401, 1977Google Scholar
  23. 23.
    Ganz PA, Rowland JH, Meyerowitz BE, Desmond KA: Impact of different adjuvant therapy strategies on quality of life in breast cancer survivors. Recent Results Cancer Res 152: 396–411, 1998PubMedGoogle Scholar
  24. 24.
    Ware JE: SF-36 Physical and Mental Health Summary Scales: A User's Manual. The Health Institute, New England Medical Center, Boston, MA, 1994Google Scholar
  25. 25.
    Beeber LS, Shea J, McCorckle R: The Center for Epidemiologic Studies Depression Scale as a measure of depressive symptoms in newly diagnosed patients. J Psychosoc Oncol 16: 1–20, 1998Google Scholar
  26. 26.
    Broeckel JA, Jacobsen PB, Horton J, Balducci L, Lyman GH: Characteristics and correlates of fatigue after adjuvant chemotherapy for breast cancer. J Clin Oncol 16: 1689–1696, 1998PubMedGoogle Scholar
  27. 27.
    Hann DM, Jacobsen P, Martin S, Azzarello L, Greenberg H: Fatigue and quality of life following radiotherapy for breast cancer: A comparative study. J Clin Psychol Med Settings 5: 19–33, 1998Google Scholar
  28. 28.
    Ganz PA, Lee JJ, Sim MS, Polinsky ML, Schag CAC: Exploring the influence of multiple variables on the relationship of age to quality of life in women with breast cancer. J Clin Epidemiol 45: 473–485, 1992PubMedGoogle Scholar
  29. 29.
    Jacobsen PB, Bovbjerg DH, Redd WH: Anticipatory anxiety in women receiving chemotherapy for breast cancer. Health Psychol 12: 469–475, 1993PubMedGoogle Scholar
  30. 30.
    Northouse LL, Swain MA: Adjustment of patients and husbands to the initial impact of breast cancer. Nurs Res 36: 221–225, 1987PubMedGoogle Scholar
  31. 31.
    Vinokur AD, Threatt BA, Vinokur-Kaplan D, Satariano WA: The process of recovery from breast cancer for younger and older patients. Cancer 65: 1242–1254, 1990PubMedGoogle Scholar
  32. 32.
    Pozo C, Carver CS, Noriega V, Harris SD, Robinson DS, Ketcham AS, Legaspi A, Moffat FL, Clark KC: Effects of mastectomy versus lumpectomy on emotional adjustment to breast cancer: a prospective study of the first year postsurgery. J Clin Oncol 10: 1292–1298, 1992PubMedGoogle Scholar
  33. 33.
    Manne SL, Sabbioni M, Bovbjerg DH, Jacobsen PB, Taylor KL, Redd WH: Coping with chemotherapy for breast cancer. J Beh Med 17: 41–55, 1994Google Scholar

Copyright information

© Kluwer Academic Publishers 2000

Authors and Affiliations

  • Jo Ann Broeckel
  • Paul B. Jacobsen
  • Lodovico Balducci
  • John Horton
  • Gary H. Lyman

There are no affiliations available

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