Quality of life at the end of primary treatment of breast cancer: first results from the moving beyond cancer randomized trial.

TitleQuality of life at the end of primary treatment of breast cancer: first results from the moving beyond cancer randomized trial.
Publication TypeJournal Article
Year of Publication2004
AuthorsGanz PA, Kwan L, Stanton AL, Krupnick JL, Rowland JH, Meyerowitz BE, Bower JE, Belin TR
JournalJ Natl Cancer Inst
Date Published2004 Mar 3
KeywordsAdult, Affect, Aged, Breast Neoplasms, Chemotherapy, Adjuvant, Depression, Female, Health Status, Humans, Mastectomy, Middle Aged, Patient Education as Topic, Patient Selection, Quality of Life, Radiotherapy, Adjuvant, Regression Analysis, Research Design, Sexual Behavior, Surveys and Questionnaires, Treatment Outcome

BACKGROUND: During the last decade, survival rates for breast cancer have increased as a result of earlier detection and increased use of adjuvant therapy. Limited data exist on the psychosocial aspects of the transitional period between the end of primary treatment and survivorship. We investigated the baseline psychosocial status of women enrolled in a randomized trial testing two psychosocial interventions for women at the end of primary treatment.

METHODS: Participants, identified within 1 month after surgery (registration), provided demographic information and limited measures of quality of life. They were followed until they finished primary treatment (enrollment), at which time they completed a mailed baseline survey that included standardized measures of quality of life (including standardized scales of physical and emotional functioning), mood, symptoms, and sexual functioning. A total of 558 patients (mean age = 56.9 years) were enrolled in the study between July 1, 1999, and June 30, 2002. Health outcomes were examined according to treatment received: mastectomy with and without chemotherapy, and lumpectomy with and without chemotherapy. All statistical tests were two-sided.

RESULTS: Among all treatment groups, patients who had a mastectomy had the poorest physical functioning at registration (P<.001) and at enrollment (P=.05). At enrollment, mood and emotional functioning were similar among all patients, with no differences by type of treatment received. At enrollment, symptoms, including muscle stiffness, breast sensitivity, aches and pains, tendency to take naps, and difficulty concentrating, were common among patients in all groups and were statistically significantly associated with poor physical functioning and emotional well-being. Sexual functioning was worse for women who received chemotherapy than for those who did not, regardless of type of surgery (P<.001).

CONCLUSIONS: At the end of primary treatment for breast cancer, women in all treatment groups report good emotional functioning but report decreased physical functioning, particularly among women who have a mastectomy or receive chemotherapy. Clinical interventions to address common symptoms associated with treatment should be considered to improve physical and emotional functioning at the end of primary treatment for breast cancer.

Alternate JournalJ. Natl. Cancer Inst.
PubMed ID14996859
Grant ListR01-CA63028 / CA / NCI NIH HHS / United States