gms | German Medical Science

50. Jahrestagung der Deutschen Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie (gmds)
12. Jahrestagung der Deutschen Arbeitsgemeinschaft für Epidemiologie (dae)

Deutsche Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie
Deutsche Arbeitsgemeinschaft für Epidemiologie

12. bis 15.09.2005, Freiburg im Breisgau

Persistence of restrictions in quality of life from the first to the third year after diagnosis in women with breast cancer

Meeting Abstract

  • Volker Arndt - Deutsches Zentrum für Alternsforschung, Heidelberg
  • Christa Stegmaier - Epidemiologisches Krebsregister Saarland, Saarbrücken
  • Hartwig Ziegler - Epidemiologisches Krebsregister Saarland, Saarbrücken
  • Hermann Brenner - Deutsches Zentrum für Alternsforschung, Heidelberg

Deutsche Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie. Deutsche Arbeitsgemeinschaft für Epidemiologie. 50. Jahrestagung der Deutschen Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie (gmds), 12. Jahrestagung der Deutschen Arbeitsgemeinschaft für Epidemiologie. Freiburg im Breisgau, 12.-15.09.2005. Düsseldorf, Köln: German Medical Science; 2005. Doc05gmds068

The electronic version of this article is the complete one and can be found online at:

Published: September 8, 2005

© 2005 Arndt et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.




Breast cancer is the most common cancer in women, accounting for approximately one third of all cancers in females. Due to advances in early diagnosis and therapy the prognosis of breast cancer has improved over the last decades. Five year relative survival estimates of around 86% indicate that the vast majority of women with breast cancer are now becoming long term survivors [1]. Therefore, in addition to disease-free and overall survival, issues of cancer survivorship including quality of life (QOL) are particularly relevant for this form of cancer.

We recently have found that deficits in role and emotional functioning are main factors hampering quality of life (QOL) in women with breast cancer one year after diagnosis and seem to affect predominantly younger patients [2]. We now address the question whether these detriments persist over a longer period and whether low levels of self-reported quality of life is associated with worse prognosis.


We assessed changes in QOL between the first and third year after diagnosis in a population based sample of 314 women with breast cancer from Saarland (Germany). Quality of life was measured with the Quality of Life Questionnaire Core 30 Items (QLQ-C30) of the European Organization for Research and Treatment of Cancer (EORTC) [3] and the breast cancer specific module BR-23 also developed by the EORTC [4]. 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 [5].


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 meaningful deficits were observed for emotional, cognitive, role and social functioning and for the symptom subscales fatigue, dyspnoea, 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 oedema 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.

Thirty-one women with breast cancer (9.9%) died between the first and the third year of follow-up. Low physical (PF) and social functioning (SF) as well as impaired overall quality of life after one year past diagnosis were associated with poorer prognosis (mortality increased by 10-15% per 10 unit decrease in PF, SF and QOL), but the differences were not statistically significant after controlling for age and tumour stage.


Deficits in role, emotional, cognitive, and social functioning persist over years in women with breast cancer. The results also show that predominantly younger women are affected.


This study was supported by the German Cancer Foundation (Deutsche Krebshilfe), Project Numbers 70-1816 and 70-2413.


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