The Effects of Surgery Type and Chemotherapy on Early-Stage Breast Cancer Patients’ Quality of Life Over 2-Year Follow-up

Abstract

Purpose We examined the effects of surgery type and adjuvant chemotherapy on change in early-stage breast cancer patients' quality of life (QOL) over time. Methods A cohort of 549 patients (33.5% ductal carcinoma in situ, 66.5% stages I/IIA) were interviewed a mean 6.1 weeks (Time1), and 6.2 (Time2), 12.3 (Time3), and 24.4 (Time4) months following definitive breast-conserving surgery (BCS) or mastectomy. QOL was measured using the total Functional Assessment of Cancer Therapy-Breast (FACT-B). Adjusting for demographic, psychosocial, and clinical variables, multiple linear regression models estimated the associations between QOL and each of surgery type, chemotherapy and their 2-way interaction at each interview. Adjusted Generalized Estimating Equation (GEE) models tested Time1-Time4 change in QOL. Results At T2, chemotherapy (P < 0.001) and BCS (P < 0.001) were independently associated with worse QOL in adjusted linear regression, and the adverse effect of chemotherapy was prominent among patients who received BCS compared with those who received mastectomy (Pinteraction = 0.031). In the GEE model, QOL significantly improved over time among patients who received BCS (Ptrend = 0.047), mastectomy (Ptrend = 0.024), and chemotherapy (Ptrend < 0.001) but not among patients who did not receive chemotherapy (Ptrend = 0.720). All patients completed adjuvant chemotherapy and radiation by Time3. Regardless of surgery type, patients receiving chemotherapy reported lower QOL following surgery, and QOL improved after completion of adjuvant treatment. Conclusions Chemotherapy had a short-term negative impact on QOL after definitive surgical treatment regardless of surgery type. QOL rebounded after completion of adjuvant treatment.

Accelerated partial breast irradiation compared with whole breast radiation therapy: a breast cancer cohort study measuring change in radiation side-effects severity and quality of life

“…However, since breast cancer patients treated with RT report persistent fatigue years after completing treatment [49,70] and cancer-related fatigue is associated with worse QOL in long-term breast cancer survivors [70], future research is warranted to determine if less severe RT-related side effects in the short-term are associated with improved long-term QOL in breast cancer survivors. Jeffe et al reported that the adverse effect of chemotherapy on total FACT-B scores was more prominent in early-stage breast cancer patients who received BCS than mastectomy, suggesting that this finding was potentially due to the cumulative effects of RT following BCS [71]. Findings reported here suggest further that the negative cumulative effect of RT on change in both Vitality and the FACT-B total scores over two-year follow-up occurs regardless of type of RT received after definitive surgical treatment.…”

Quality of life, fatigue and changes therein as predictors of return to work during breast cancer treatment

“…These studies suggest that youth increases the likelihood of RTW in the year after diagnosis (11,12), and that chemotherapy is the major medical barrier to RTW (10,12,13). Indeed, the deleterious impact of chemotherapy on quality of life 1 (QOL) is well-known (15,16).…”

The impact of physical activity on fatigue and quality of life during and after adjuvant treatment for breast cancer

“…Quality of life (QoL) is an important consideration in oncology, particularly for patients with BC, and can also be affected by treatments . Maintenance of and improvements in QoL for patients with cancer during and after treatment are major concerns in oncology, because treatments are often intensive and traumatic .…”

“…1 Quality of life (QoL) is an important consideration in oncology, particularly for patients with BC, and can also be affected by treatments. 4,5 Maintenance of and improvements in QoL for patients with cancer during and after treatment are major concerns in oncology, because treatments are often intensive and traumatic. 6 For instance, the type of surgery or adjuvant therapy can induce several side effects and symptoms, such as anxiety or sleep disturbance, that can negatively affect personality and QoL.…”