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Health related quality of life in different states of breast cancer

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Abstract

Objectives

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.

Results

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.

Conclusion

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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Notes

  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.

References

  1. The National Board of Health, Welfare. (2005). Cancer Incidence in Sweden 2004. Stockholm: Official Statistics of Sweden.

    Google Scholar 

  2. The National Board of Health and Welfare. (2005). Causes of death 2003. Stockholm: Official Statistics of Sweden.

    Google Scholar 

  3. Slamon, D. J., Leyland-Jones, B., Shak, S., et al. (2001). Use of chemotherapy plus a monoclonal antibody against HER2 for metastatic breast cancer that overexpresses HER2. The New England Journal of Medicine, 344(11), 783–792.

    Article  PubMed  CAS  Google Scholar 

  4. Bishop, J. F., Dewar, J., Toner, G. C., et al. (1999). Initial paclitaxel improves outcome compared with CMFP combination chemotherapy as front-line therapy in untreated metastatic breast cancer. Journal of Clinical Oncology, 17(8), 2355–2364.

    PubMed  CAS  Google Scholar 

  5. Chan, S., Friedrichs, K., Noel, D., et al. (1999). Prospective randomized trial of docetaxel versus doxorubicin in patients with metastatic breast cancer. Journal of Clinical Oncology, 17(8), 2341–2354.

    PubMed  CAS  Google Scholar 

  6. Drummond, M., Sculpher, M., Torrance, G., O’Brien, B., & Stoddart G. (2005). Methods for the Economic Evaluation of Health Care Programmes. 3rd ed. Oxford: Oxford Medical Publications.

    Google Scholar 

  7. Torrance, G. (1976). Social preferences for health states: An empirical evaluation of three measurments techniques. Socio-Economic Planning Sciences, 10, 129–136.

    Article  Google Scholar 

  8. EuroQol Group. (1990). EuroQol—A new facility for the measurment of health-related quality of life. Health Policy, 16, 199–208.

    Article  Google Scholar 

  9. EuroQol Group hompage. http://www.euroqol.org. Accessed November 2nd, 2006.

  10. Dolan, P. (1997). Modeling valuations for EuroQol health states. Medical Care, 35(11), 1095–1108.

    Article  PubMed  CAS  Google Scholar 

  11. Gold, M., Siegel, J., Russel, L., & Wienstein, M. (1996). Cost-effectiveness in health and medicine. New York: Oxford University Press.

    Google Scholar 

  12. Johannesson, M. (1996). Theory and Methods of Economic Evaluation of Health. Care: Kluwer Academic Publisher.

    Google Scholar 

  13. Conner-Spady, B. L., Cumming, C., Nabholtz, J. M., Jacobs, P., & Stewart, D. (2005). A longitudinal prospective study of health-related quality of life in breast cancer patients following high-dose chemotherapy with autologous blood stem cell transplantation. Bone Marrow Transplant, 36(3), 251–259.

    Article  PubMed  CAS  Google Scholar 

  14. Perez, D. J., Williams, S. M., Christensen, E. A., McGee, R. O., & Campbell, A. V. (2001). A longitudinal study of health related quality of life and utility measures in patients with advanced breast cancer. Quality of Life Research, 10(7), 587–593.

    Article  PubMed  CAS  Google Scholar 

  15. Jansen, S. J., Kievit, J., Nooij, M. A., & Stiggelbout, A. M. (2001). Stability of patients’ preferences for chemotherapy: The impact of experience. Medical Decision Making, 21(4), 295–306.

    Article  PubMed  CAS  Google Scholar 

  16. Hall, J., Gerard, K., Salkeld, G., & Richardson, J. (1992). A cost utility analysis of mammography screening in Australia. Social Science & Medicine, 34(9), 993–1004.

    Article  CAS  Google Scholar 

  17. Earle, C. C., Chapman, R. H., Baker, C. S., et al. (2000). Systematic overview of cost-utility assessments in oncology. Journal of Clinical Oncology, 18(18), 3302–3317.

    PubMed  CAS  Google Scholar 

  18. Briggs, A. H., Wonderling, D. E., & Mooney, C. Z. (1997). Pulling cost-effectiveness analysis up by its bootstraps: A non-parametric approach to confidence interval estimation. Health Economics, 6(4), 327–340.

    Article  PubMed  CAS  Google Scholar 

  19. Burstrom, K., Johannesson, M., & Diderichsen, F. (2006). A comparison of individual and social time trade-off values for health states in the general population. Health Policy, 76(3), 359–370.

    Article  PubMed  Google Scholar 

  20. Zethraeus, N., & Johannesson, M. (1999). A comparison of patient and social tariff values derived from the time trade-off method. Health Economics, 8(6), 541–545.

    Article  PubMed  CAS  Google Scholar 

  21. Svenska bröstcancergruppen. (2003). Nationellt vårdprogram för bröstcancer. Stockholm.

  22. Wilson, R. W., Hutson, L. M., & Vanstry, D. (2005). Comparison of 2 quality-of-life questionnaires in women treated for breast cancer: The RAND 36–Item Health Survey and the Functional Living Index-Cancer. Physical Therapy, 85(9), 851–860.

    PubMed  Google Scholar 

  23. Whelan, T. J., Goss, P. E., Ingle, J. N., et al. (2005). Assessment of quality of life in MA.17: A randomized, placebo-controlled trial of letrozole after 5 years of tamoxifen in postmenopausal women. Journal of Clinical Oncology, 23(28), 6931–6940.

    Article  PubMed  CAS  Google Scholar 

  24. Wardley, A., Davidson, N., Barrett-Lee, P., et al. (2005). Zoledronic acid significantly improves pain scores and quality of life in breast cancer patients with bone metastases: A randomised, crossover study of community vs hospital bisphosphonate administration. British Journal of Cancer, 92(10), 1869–1876.

    Article  PubMed  CAS  Google Scholar 

  25. Schou, I., Ekeberg, O., Sandvik, L., Hjermstad, M.J., & Ruland, C. M. (2005). Multiple predictors of health-related quality of life in early stage breast cancer. Data from a year follow-up study compared with the general population. Quality of Life Research, 14(8), 1813–1823.

    Article  PubMed  Google Scholar 

  26. Peppercorn, J., Herndon, J., 2nd, Kornblith, A. B., et al. (2005). Quality of life among patients with Stage II and III breast carcinoma randomized to receive high-dose chemotherapy with autologous bone marrow support or intermediate-dose chemotherapy: Results from Cancer and Leukemia Group B 9066. Cancer, 104(8), 1580–1589. Oct 15.

    Google Scholar 

  27. Kendall, A. R., Mahue-Giangreco, M., Carpenter, C. L., Ganz, P. A., & Bernstein, L. (2005). Influence of exercise activity on quality of life in long-term breast cancer survivors. Quality of Life Research, 14(2), 361–371.

    Article  PubMed  Google Scholar 

  28. Gordon, L. G., Battistutta, D., Scuffham, P., Tweeddale, M., & Newman, B. (2005). The impact of rehabilitation support services on health-related quality of life for women with breast cancer. Breast Cancer Research and Treatment, 93(3), 217–226.

    Article  PubMed  Google Scholar 

  29. Fehlauer, F., Tribius, S., Mehnert, A., & Rades, D. (2005). Health-related quality of life in long term breast cancer survivors treated with breast conserving therapy: Impact of age at therapy. Breast Cancer Research and Treatment, 92(3), 217–222.

    Article  PubMed  Google Scholar 

  30. Elder, E. E., Brandberg, Y., Bjorklund, T., et al. (2005). Quality of life and patient satisfaction in breast cancer patients after immediate breast reconstruction: A prospective study. Breast, 14(3), 201–208.

    Article  PubMed  Google Scholar 

  31. Burckhardt, C. S., & Jones, K. D. (2005). Effects of chronic widespread pain on the health status and quality of life of women after breast cancer surgery. Health and Quality of Life Outcomes, 3(1), 30.

    Article  PubMed  Google Scholar 

  32. Avis, N. E., Crawford, S., & Manuel, J. (2005). Quality of life among younger women with breast cancer. Journal of Clinical Oncology, 23(15), 3322–3330.

    Article  PubMed  Google Scholar 

  33. Veiga, D. F., Sabino Neto, M., Ferreira L. M., et al. (2004). Quality of life outcomes after pedicled TRAM flap delayed breast reconstruction. British Journal of Plastic Surgery, 57(3), 252–257.

    Article  PubMed  CAS  Google Scholar 

  34. Schreier, A. M., & Williams, S. A. (2004). Anxiety and quality of life of women who receive radiation or chemotherapy for breast cancer. Oncology Nursing Forum, 31(1), 127–130.

    Article  PubMed  Google Scholar 

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Acknowledgment

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). https://doi.org/10.1007/s11136-007-9202-8

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  • DOI: https://doi.org/10.1007/s11136-007-9202-8

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