Introduction: Each year, around 16,500 women in Poland are diagnosed with breast cancer, the second most common cause of death in women. In Poland, nearly 70,000 women live with breast cancer diagnosed within the last 5 years. Quality of life (QoL) research is particularly important in cancer patients, as it provides knowledge on their psychological and physical health, as well as the environment in which the patients function, all of which is essential to implementing multidisciplinary care involving the best use of the appropriate methods. Carrying the burden of cancer is a major challenge for patients. The strategy that patients use to cope with breast cancer significantly affects their quality of life. The purpose of the study is to assess the impact of coping strategies on the QoL in breast cancer patients. Material and Methods: The prospective study included a group of 202 women who had undergone surgical treatment for breast cancer at the Lower Silesian Cancer Center and who reported for follow-up appointments at the Oncology Clinic and the Surgical Oncology Clinic. For the study, we used the: EORTC QLQ-C30 cancer questionnaire, EORTC QLQ-BR23 module, Mental Adjustment to Cancer (Mini-MAC) scale, visual analog scale (VAS) for pain intensity, as well as the patients’ medical records, hospital records, and our own survey form. Results: The mean patient age was 53 years. Most patients had been diagnosed with cancer between one and two years before. In the women studied, there was a negative association between QoL and the choice of a destructive strategy for coping with cancer, and a positive one between QoL and a constructive coping strategy. Severe pain caused by the disease and its treatment significantly decreased the patients’ QoL in multiple domains. Conclusions: Patients choosing constructive strategies obtained higher QoL scores, while greater reliance on destructive coping strategies was associated with significantly worse QoL. In all functioning domains, higher levels of pain were associated with poorer QoL and more severe symptoms associated with the disease and its treatment.

Introduction. In 2020, breast cancer was the most frequently diagnosed malignancy worldwide. The QoL level plays a role in assessing the effectiveness of the diagnosis and therapy and is a significant prognostic factor. The subject that is relatively less often addressed in the literature is the impact of psycho-social factors and health-related beliefs on QoL in breast cancer patients. The aim of the study was to assess the association of illness perception, the sense of coherence, and illness acceptance with QoL in breast cancer patients. Methods. The study included 202 women (mean age 53.0 ± 10.3) treated surgically for breast cancer at the Lower Silesian Oncology Centre. The following standardized questionnaires were used: Acceptance of Illness Scale (AIS), Mental Adjustment to Cancer (Mini-MAC), Quality of Life Questionnaires (EORTC QLQ-C30 and QLQ-BR23), The Multidimensional Essence of Disease and Illness Scale (MEDIS), and Life Orientation Test (LOT-R). Results. There is a statistically significant association between illness acceptance and QoL. There is a statistically significant association between the sense of coherence (life optimism—LOT-R) and QoL among breast cancer patients. There is a statistically significant association between illness perception and QoL. There was a statistically significant correlation between the increasing importance of illness as a dysfunction, decreasing QoL, and increasing intensity of symptoms and complaints. Conclusions. Patients with a high level of illness acceptance, with an optimistic disposition, and with a positive illness perception have better QoL within all the functional domains and experience lower intensity of cancer- and treatment-related symptoms as compared to those with low level of illness acceptance, with moderate optimism or a pessimistic disposition, and with neutral or negative illness perception.

Introduction: Breast cancer is the most common cause of cancer death in women. Aim: The aim of the study was to investigate the association between illness acceptance and quality of life (QoL) in patients with breast cancer. Patients and Methods: The study included 150 patients who had undergone surgery for breast cancer. The following standardized questionnaires were used: the Acceptance of Illness Scale (AIS), the EORT QLQ-C30 (The European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30), and the EORT QL-BR 23 (Quality of Life Questionnaire for Breast Cancer) for QoL evaluation. Socio-clinical data were obtained from the patients' medical records. Results: In the study group, the overall QoL score was 62.67±17.11 in the BCT group, 63 ±14.3 in the MTX group, and the highest: 65.5±20.2 in the reconstruction group. Comparative analysis showed that patients in the BCT group reported significantly more fatigue (p=0.007) and appetite loss (p=0.032) than those in the MTX+R group. Patients in the MTX group were significantly less satisfied with their body image (p=0.001) and experienced more financial troubles (p=0.013) than the remaining patients. Patients in the MTX+R group reported significantly better sexual function and more sexual enjoyment than the remaining patients (p<0.001). All patients scored high for illness acceptance, though patients in the MTX group had lower scores (28.17±7.2) than the others: 31.84±6.51 in the BCT group and 32.78±7.97 in the MTX+R group. The comparative analysis of QoL according to the level of AIS showed the significantly better QoL and less intense symptoms within all the domains except for the insomnia and hair loss domains in the group of high AIS in comparison with medium and lack of AIS. Acceptance of illness significantly correlated with 4 domains of the QLQ-C30 (p<0.05). The correlation between illness acceptance and overall QoL was positive (r=0.243; p=0.003)-the higher the acceptance, the better the QoL. Correlations with pain, diarrhoea, and financial difficulties were negative. Illness acceptance was positively correlated with QoL in 3 domains of the EORTC-BR23: body image (p<0.001), sexual function (p=0.015), and sexual enjoyment (p=0.047), and negatively with the "treatment side effects" (p=0.011). Conclusion: The level of illness acceptance varies depending on the treatment method, and is the lowest in the group of women having undergone a mastectomy, and the highest in patients after a mastectomy with immediate breast reconstruction. Acceptance of illness improves the QoL of women treated for breast cancer, regardless of the specific treatment method.

Jakość życia pacjentek z rozpoznaniem nowotworu piersiQuality of life in patients diagnosed with breast cancer Streszczenie Rak piersi stanowi drugą co do częstości przyczynę zgonów spowodowanych przez nowotwory złośliwe u kobiet. Rak piersi we wczesnych stadiach rozwoju nie wywołuje objawów, jednak w okresie zaawansowanej choroby powoduje liczne objawy fizyczne, ale także zaburza funkcjonowanie w sferze psychologicznej, społecznej, rodzinnej, seksualnej i duchowej. Jakość życia związana ze stanem zdrowia stanowi najważniejszy aspekt życia każdego człowieka. Kobiety z rozpoznaniem raka piersi cechuje obniżona jakość życia, w porównaniu z populacją zdrową. Ocena jakości życia kobiet z rakiem piersi, jako chorobą dającą odległe skutki, jest niezwykle istotna, również dla powodzenia leczenia przeciwnowotworowego i objawowego. Wśród czynników warunkujących jakość życia wymieniane są 4 grupy: zmienne socjodemograficzne, zmienne kliniczne, czynniki psychosocjalne i przekonania zdrowotne. Ocena jakości życia pozwala dobrać korzystne dla pacjentki leczenie, a poziom jakości życia posiada także znaczenie rokownicze. Interwencje mające na celu poprawę jakości życia mogą wydłużyć czas przeżycia kobiet z rakiem piersi. AbstractBreast cancer is the second most common cause of death caused by malignant tumors in women. Initially, breast cancer does not give symptoms, but then it manifests itself not only with unpleasant physical and mental symptoms, but also disturbs functioning in the social, family or sexual sphere. The quality of life associated with the state of health is the most important aspect of every human life. Unfortunately, women with breast cancer still have a reduced quality of life in relation to the healthy population. Assessing the quality of life of women with breast cancer as a disease with long-term effects is extremely important also for the success of the therapy. Among the determinants of quality of life 4 groups are mentioned: sociodemographic variables, clinical variables, psychosocial factors and health convictions. The assessment of quality of life allows us to choose a treatment beneficial for the patient and also has prognostic importance. Interventions to improve the quality of life can increase the survival of women with breast cancer. Palliat Med Pract 2018; 12, 3: 143-150