Health-related quality of life in long-term early-stage breast cancer survivors compared to general population in Korea

Thi Xuan Mai Tran ¹, So-Youn Jung ², Eun-Gyeong Lee ², Heeyoun Cho ³, Na Yeon Kim ⁴, Sungkeun Shim ⁵, Ho Young Kim ⁴, Danbee Kang ^5 6, Juhee Cho ^5 6, Eunsook Lee ^2 7, Yoonjung Chang ^# 8 9, Hyunsoon Cho ^# 10 11

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• PMID: 37999857
•  
• DOI: 10.1007/s11764-023-01482-2

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Abstract

Purpose: This study assessed health-related quality of life (HRQoL) of long-term breast cancer (BC) survivors diagnosed at early stages and compare with cancer-free, age-matched women.

Methods: The study population included BC survivors diagnosed with ductal carcinoma in situ (DCIS) or breast cancer stages I-II, who had undergone lumpectomy/mastectomy, with time since diagnosis ranging from 9 to 16 years. Survey was conducted at two tertiary hospitals in 2020. Data for cancer-free female controls was randomly drawn from a population-based survey and age-, education-matched with 1 case: 3 controls ratio. Self-reported HRQoL was assessed using EQ-5D with five dimentions. EQ-5D utility index score was calculated. Difference in EQ-5D score was evaluated using the Tobit regression model with adjustment for other covariates.

Results: Of 273 survivors. 88% and 12% underwent mastectomy and lumpectomy, respectively. The mean (standard deviation, SD) age at survey was 57.3 (8.5) years old. BC survivors reported significantly more problems performing daily activities (11% vs. 5%, p < 0.001), pain/discomfort (46% vs. 23%, p < 0.001), and anxious/depressed feelings (44% vs. 8%, p < 0.001) relative to the controls. Difference in EQ-5D score between BC survivors and the general population was higher in older age groups. The overall EQ-5D score of BC survivors was statistically lower than that of the control subjects (adjusted [Formula: see text]=0.117, p < 0.001).

Conclusion: Long-term BC survivors who survived beyond ten years post-diagnosis experience more pain, anxiety, and distress, leading to an overall poorer HRQoL.

Implications for cancer survivors: This study suggest the importance of follow-up care, particularly focusing on pain, anxiety, and distress management to enhance the HRQoL of long-term BC survivors.

Keywords: Anxiety; Breast cancer survivor; Depression; Health-related quality of life; Pain.

© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.