Quality of life among a population-based cohort of older patients with breast cancer. Breast 2014 Oct;23(5):609-16
Date
07/19/2014Pubmed ID
25034932Pubmed Central ID
PMC4184951DOI
10.1016/j.breast.2014.06.002Scopus ID
2-s2.0-84908209123 (requires institutional sign-in at Scopus site) 36 CitationsAbstract
BACKGROUND: Growing numbers of older women receive adjuvant breast cancer therapies, but little is known about the long-term effects of current therapies upon health-related quality of life outside of clinical trials.
METHODS: A population-based cohort of postmenopausal women with incident breast cancer aged sixty-five and older was identified from Medicare claims from four states and followed over five years. General health-related quality of life (HRQOL) was assessed using the Medical Outcomes Study SF-12 Health Survey, and breast cancer-related HRQOL was assessed using the breast cancer subscale of the functional assessment of cancer therapy (FACT-B BCS). The association of HRQOL with sociodemographic variables, comorbidity, and breast cancer variables (stage, treatments, and treatment sequelae) was examined in longitudinal models.
RESULTS: Among the 3083 older breast cancer survivors, general HRQOL as measured by SF-12 mental and physical component scores was similar to norms for non-cancer populations, and remained stable throughout follow-up. Breast cancer treatments, including surgery and radiation, adjuvant hormonal therapy, and cytotoxic chemotherapy were not associated with worsened general health scores. A similar pattern was seen for breast cancer-related HRQOL scores, except that chemotherapy was associated with slightly worse scores. Lymphedema occurred in 17% of the cohort, and was strongly associated with all measures of HRQOL. Reductions in general HRQOL with lymphedema development were larger than those with an age increase of 10 years.
CONCLUSIONS: There is little association of breast cancer treatment with HRQOL in older breast cancer patients followed for up to five years, but the development of lymphedema is associated with substantial reductions in HRQOL.
Author List
Neuner JM, Zokoe N, McGinley EL, Pezzin LE, Yen TW, Schapira MM, Nattinger ABAuthors
Emily L. McGinley Biostatistician III in the Center for Advancing Population Science department at Medical College of WisconsinAnn B. Nattinger MD, MPH Associate Provost, Professor in the Medicine department at Medical College of Wisconsin
Joan Neuner MD, MPH Professor in the Medicine department at Medical College of Wisconsin
Liliana Pezzin PhD, JD Professor in the Institute for Health and Equity department at Medical College of Wisconsin
Tina W F Yen MD, MS Professor in the Surgery department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
Age FactorsAged
Aged, 80 and over
Breast Neoplasms
Combined Modality Therapy
Female
Follow-Up Studies
Health Surveys
Humans
Lymphedema
Models, Statistical
Quality of Life
Surveys and Questionnaires
United States
