Artikel
Persistence of restrictions in quality of life over three years in women with breast cancer: a population-based study
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Autoren
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Volker Arndt
- Deutsches Zentrum für Alternsforschung, Heidelberg; Deutsches Krebsforschungszentrum, Heidelberg, Deutschland
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Christa Stegmaier
- Ministerium für Justiz, Gesundheit und Soziales, Gesundheitsberichterstattung Saarland - Krebsregister, Saarbrücken
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Hartwig Ziegler
- Ministerium für Justiz, Gesundheit und Soziales, Gesundheitsberichterstattung Saarland - Krebsregister, Saarbrücken
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Hermann Brenner
- Deutsches Zentrum für Alternsforschung, Heidelberg; Deutsches Krebsforschungszentrum, Heidelberg
| Veröffentlicht: | 20. März 2006 |
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Gliederung
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Background: Breast cancer is the most common cancer among women in Germany, accounting for over 47000 new cases each year. Due to advances in early diagnosis and therapy the prognosis of breast cancer has improved over the last decades and the vast majority of women with breast cancer are now becoming long term survivors. Therefore, in addition to disease-free and overall survival, issues of cancer survivorship including quality of life (QOL) are becoming increasingly important.
Methods: We assessed QOL one and three years after diagnosis in a population-based sample of 314 women with breast cancer from Saarland (Germany) with the Quality of Life Questionnaire Core 30 Items (QLQ-C30) and the breast cancer specific module BR-23. Of those who survived, 88% returned the questionnaire. Functional and symptom QOL-scores were compared internally and with reference data from the German general population.
Results: Three years after diagnosis women with breast cancer scored their physical functioning and global quality of life similar to age matched women from the general population. However, clinically relevant deficits were observed for emotional, cognitive, role and social functioning and for the symptom subscales fatigue, dyspnea, insomnia and financial difficulties. The differences regarding functional and symptom scores were predominantly found in younger ages. Compared with the QOL scores measured at the end of the first year after diagnosis only minor functional changes were observed in the entire study population as well as in different age groups.
Among the breast cancer specific items, arm symptoms appear to be particularly relevant. Over 80% of all women reported restrictions in mobility, pain, and edema which persisted during the follow-up period. Improvements, if any, were seen with respect to less financial difficulties, a better future perspective, and less breast symptoms.
Recurrence of breast cancer during the follow-up interval occurred in 15 women and had a deleterious effect on QOL. Dramatic impairments were observed for all function scales and all symptom scales including body image, future perspective, arm symptoms, systemic side effects and hair loss.
Conclusions: Deficits in role, emotional, cognitive, role and social functioning persist over years in women with breast cancer. Our study also indicates that predominantly younger women are affected.
