Health-related quality of life in Asian patients with breast cancer: a systematic review

Abstract

ObjectiveTo summarise the evidence on determinants of health-related quality of life (HRQL) in Asian patients with breast cancer.DesignSystematic review conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations and registered with PROSPERO (CRD42015032468).MethodsAccording to the PRISMA guidelines, databases of MEDLINE (PubMed), Embase and PsycINFO were systematically searched using the following terms and synonyms: breast cancer, quality of life and Asia. Articles reporting on HRQL using EORTC-QLQ-C30, EORTC-QLQ-BR23, FACT-G and FACT-B questionnaires in Asian patients with breast cancer were eligible for inclusion. The methodological quality of each article was assessed using the quality assessment scale for cross-sectional studies or the Newcastle-Ottawa Quality Assessment Scale for cohort studies.ResultsFifty-seven articles were selected for this qualitative synthesis, of which 43 (75%) were cross-sectional and 14 (25%) were longitudinal studies. Over 75 different determinants of HRQL were studied with either the EORTC or FACT questionnaires. Patients with comorbidities, treated with chemotherapy, with less social support and with more unmet needs have poorer HRQL. HRQL improves over time. Discordant results in studies were found in the association of age, marital status, household income, type of surgery, radiotherapy and hormone therapy and unmet sexuality needs with poor global health status or overall well-being.ConclusionsIn Asia, patients with breast cancer, in particular those with other comorbidities and those treated with chemotherapy, with less social support and with more unmet needs, have poorer HRQL. Appropriate social support and meeting the needs of patients may improve patients’ HRQL.

Assessment of age-related influences on the quality of life of breast cancer patients before and after surgical treatment

“…Most QoL studies of breast cancer patients have shown that younger age was a risk factor for lower QoL as well as for significant stress after treatment 15,[16][17][18][19] . On the other hand, it has been observed that there was an improvement in the perceived QoL in all domains regardless of therapeutic modality.…”

Patient‐reported outcome measures among breast cancer survivors: A cross‐sectional comparison between Malaysia and high‐income countries

“…16 Given that the majority of the research on PROs has been conducted in developed or HICs, it is important to understand the differences or similarities in how women in low and middle income countries (LMICs) interpret their cancer care priorities. 17,18 In LMICs, the differences in socioeconomic status, 19 health literacy, 20 the condition of the healthcare system, and various mitigating factors could deeply influence the perceptions and outcomes for breast cancer survivors. Therefore, we hypothesize that breast cancer survivors' priorities will differ between LMICs and HICs, as well as within populations.…”

Aerobic capacity correlates with health‐related quality of life after breast cancer surgery

“…In a previous study, it was found that overall QOL is reduced and is consistently lower in patients receiving chemotherapy (Wöckel et al, ). According to the recently published systematic review, chemotherapy is a significant factor that affects overall QOL in breast cancer patients, but the effects of age, stage and other treatment including surgical method are unclear (Ho et al, ). This is consistent with our findings that only chemotherapy is a factor affecting overall QOL among the factors associated with the cancer‐related treatments and cancer itself.…”

“…Therefore, the importance of rehabilitation for improving HRQOL and physical limitations of breast cancer survivors has been emerged (Foley, Hasson, & Kendall, ; Leclerc et al, ; Simonavice et al, ). Previous cancer rehabilitation has targeted patients who have been completed treatment for breast cancer, but since the HRQOL of breast cancer patients is reduced immediately after the surgery, there is a growing interest in rehabilitation for patients during breast cancer treatment (Fu et al, ; Ho, Gernaat, Hartman, & Verkooijen, ). One of the recent trends in the rehabilitation approach of breast cancer patients is early, multidisciplinary palliative rehabilitation, reflecting claims that comprehensive rehabilitation should be provided early to patients during cancer treatment (Leclerc et al, ).…”

“…For successful rehabilitation, a systematic and comprehensive assessment of the patient's condition at the beginning of rehabilitation should be preceded. Patients with breast cancer are known to have decreased HRQOL and physical activity not only at the time of treatment completion, but also during treatment (Fu et al, 2015;Ho et al, 2018) However, there are few studies on changes of physical functions and body composition during the breast cancer-related treatment. Most of the breast cancer-related treatments are performed within 1 year after surgery, with the most complications occurring at this time (Fu et al, 2015).…”