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

• Published in: Journal of cancer survivorship Vol. 17; no. 5; pp. 1416 - 1426
• Main Authors: Tran, Thi Xuan Mai, Jung, So-Youn, Lee, Eun-Gyeong, Cho, Heeyoun, Cho, Juhee, Lee, Eunsook, Chang, Yoon Jung, Cho, Hyunsoon
• Format: Journal Article
• Language: English
• Published: New York Springer US 01-10-2023; Springer Nature B.V
• Subjects: Breast cancer; Complications; Diagnosis; Fatigue; Health Informatics; Health Promotion and Disease Prevention; Insomnia; Medicine; Medicine & Public Health; Oncology; Original Research; Pain; Primary Care Medicine; Public Health; Quality of life; Quality of Life Research; Sleep disorders; Survival; Health-related quality of life; Long-term cancer survivors; Breast cancer; Pain; Fatigue; Insomnia
• ISSN: 1932-2259; 1932-2267
• DOI: 10.1007/s11764-022-01165-4

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.