World Journal of Surgery

, Volume 43, Issue 1, pp 44–51 | Cite as

Assessing the Quality of Life of Patients with Breast Cancer Treated in a Tertiary Hospital in a Resource-Poor Country

  • Chinedu Okoli
  • S. N. C. Anyanwu
  • Amobi O. Ochomma
  • Chiemelu D. Emegoakor
  • Gabriel U. Chianakwana
  • Henry Nzeako
  • Eric Ihekwoaba
Original Scientific Report



Very few studies have assessed the quality of life (QoL) of patients living with breast cancer in a resource-poor setting like Nigeria. The aim of our study was to comprehensively examine the measures of QoL in breast cancer patients using the Functional Assessment of Cancer Therapy-Breast (FACT-B) version 4 in order to deepen the literature on QoL among breast cancer patients to include non-Western/northern patient populations.

Patients and methods

Purposive sampling of stable patients who attended general surgery clinics with histopathologically diagnosed breast cancer was done. Eligible patients were assessed using five domains of the FACT-B questionnaire including: the breast cancer-specific symptoms (BCS), emotional well-being (EWB), functional well-being (FWB), physical well-being (PWB), and social & family well-being (SWB). The questionnaire was administered in a face-to-face interview by trained research assistants. In addition, the five domains were compared among three different age categories, pre-menopausal and post-menopausal, and patients who have had surgery and chemotherapy alone. The SPSS (IBM Corp. Released in 2011. IBM SPSS Statistics for Windows, Version 20.0. Armonk, NY: IBM Corp.) and the Microsoft Excel (11. Corporation Microsoft, Redmond, WA, USA) were used for statistical analysis. Statistical significance was inferred when p <0.05.


Among the 60 enrolled participants, total score of the five domains (n = 144) was 74.59 ± 17.72, FACT-G score (n = 108) was 53.49 ± 12.56, Trial outcome index (n = 112) was 49.20 ± 13.13, PWB (n = 28) was 10.95 ± 6.37, SWB (n = 28) was 18.41 ± 6.48, EWB (n = 24) was 6.98 ± 4.15, FWB (n = 28) was 17.15 ± 7.12, and the BCS (n = 36) was 21.10 ± 8.93. EWB was significantly less in post-mastectomy patients on adjuvant chemotherapy (p = 0.031) and pre-menopausal women (p = 0.041) as well as in patients less than 40 years when compared with patients more 50 years (p = 0.049).


Breast cancer patients in resource-poor countries have a profoundly impaired quality of life. This study showed significantly lower emotional well-being domain scores in post-mastectomy patients on adjuvant chemotherapy, pre-menopausal women having breast cancer and in younger female patients. There is need to address this anomaly.


Compliance with ethical standards

Conflict of interest

No conflict of interest was declared by the authors.

Informed consent

Written informed consent was obtained from patients who participated in this study.


  1. 1.
    Ferlay J, Soerjomataram I, Dikshit R et al (2015) Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer 136:359–386CrossRefGoogle Scholar
  2. 2.
    Jedy-Agba E, Curado MP, Ogunbiyi O et al (2012) Cancer incidence in Nigeria: a report from population-based cancer registries. Cancer Epidemiol 36:271–278CrossRefGoogle Scholar
  3. 3.
    Ezeome ER (2010) Delays in presentation and treatment of breast cancer in Enugu, Nigeria. Niger J Clin Pract 13:311–316Google Scholar
  4. 4.
    Office for National Statistics. Cancer survival in Enland: patients diagnosed between 2010 and 2014 and followed up to 2015. Accessed 18 July 2018
  5. 5.
    Joulaee A, Joolaee S, Kadivar M et al (2012) Living with breast cancer: Iranian women’s lived experiences. Int Nurs Rev 59:362–368CrossRefGoogle Scholar
  6. 6.
    Perry SH, Kowalski TL, Chang CH (2007) Quality of life assessment in women with breast cancer: benefits, acceptability and utilization. Health Qual Life Outcomes 5:24–38CrossRefGoogle Scholar
  7. 7.
    Vigano A, Donaldson N, Higginson IJ et al (2004) Quality of life and survival prediction in terminal cancer patients. Cancer 101:1090–1098CrossRefGoogle Scholar
  8. 8.
    WHOQOL Group (1993) Study protocol for the World Health Organization project to develop a quality of life health organization project to develop a quality of life assessment instrument (WHOQOL). Qual Life Res 2:153–159CrossRefGoogle Scholar
  9. 9.
    Jaiyesimi AO, Sofela EA, Rufai AA (2007) Health-related quality of life and its determinants in Nigerian breast cancer patients. AJMMS 36:259–265Google Scholar
  10. 10.
  11. 11.
    WHO (2015) Current health expenditure as a percentage of gross domestic product (GDP). Accessed 18 July 2018
  12. 12.
  13. 13.
    World Medical Association (2013) World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA 310:2191CrossRefGoogle Scholar
  14. 14.
    Webster K, Cella D, Yost K (2003) The functional assessment of chronic illness therapy (FACIT) measurement system: properties, applications, and interpretation. Health Qual Life Outcomes 1:79CrossRefGoogle Scholar
  15. 15.
    Yost KJ, Yount SE, Eton DT et al (2005) Validation of the functional assessment of cancer therapy-breast symptom index (FBSI). Breast Cancer Res Treat 90:295–298CrossRefGoogle Scholar
  16. 16.
    Yoo HJ, Ahn SH, Eremenco S et al (2005) Korean translation and validation of the functional assessment of cancer therapy-breast (FACT-B) scale version 4. Qual Life Res 4:1627–1632CrossRefGoogle Scholar
  17. 17.
    Pandey M, Thomas BC, Ramdas K et al (2002) Quality of life in breast cancer patients: validation of a FACT-B Malayalam version. Qual Life Res 11:87–90CrossRefGoogle Scholar
  18. 18.
    Spagnola S, Zabora J, BrintzenhofeSzoc K et al (2003) The satisfaction with life domains scale for breast cancer (SLDS-BC). Breast J 9:463–471CrossRefGoogle Scholar
  19. 19.
    Oliveira IS, Costa L, Manzoni AC et al (2014) Assessment of the measurement properties of quality of life questionnaires in Brazilian women with breast cancer. BJPT 18:372–383Google Scholar
  20. 20.
    Beaulac SM, McNair LA, Scott TE et al (2002) Lymphedema and quality of life in survivors of early-stage breast cancer. Arch Surg 137:1253–1257CrossRefGoogle Scholar
  21. 21.
    Yan B, Yang LM, Hao LP et al (2016) Determinants of quality of life for breast cancer patients in Shanghai, China. PLoS One 11:e0153714CrossRefGoogle Scholar
  22. 22.
    Tfayli A, Temraz S, Abou Mrad R et al (2010) Breast cancer in low- and middle-income countries: an emerging and challenging epidemic. J Oncol 2010:e490631CrossRefGoogle Scholar
  23. 23.
    Cleary J, Ddungu H, Distelhorst SR et al (2013) Supportive and palliative care for metastatic breast cancer: resource allocations in low- and middle-income countries. A breast health global initiative 2013 consensus statement. The Breast 22:616–627CrossRefGoogle Scholar
  24. 24.
    Taib NA, Yip CH, Low WY (2014) A grounded explanation of why women present with advanced breast cancer. WJS 38:1676–1684CrossRefGoogle Scholar
  25. 25.
    Newell RJ (1991) Altered body image: a fear-avoidance model of psycho-social difficulties following disfigurement. J Adv Nurs 30:1230–1238CrossRefGoogle Scholar
  26. 26.
    Awadalla AW, Ohaeri JU, Gholoum A et al (2007) Factors associated with quality of life of outpatients with breast cancer and gynecologic cancers and their family caregivers: a controlled study. BMC Cancer 7:102CrossRefGoogle Scholar
  27. 27.
    Northouse L, Templin T, Mood D (2001) Couples’ adjustment to breast disease during the first year following diagnosis. IJBM 24:115–136Google Scholar
  28. 28.
    Kobeissi L, Saad MA, Doumit M et al (2014) Face validity of the functional assessment of cancer therapy-breast symptom index (FACT-) into formal Arabic. MEJC 5:151–165Google Scholar

Copyright information

© Société Internationale de Chirurgie 2018

Authors and Affiliations

  • Chinedu Okoli
    • 1
  • S. N. C. Anyanwu
    • 1
  • Amobi O. Ochomma
    • 1
  • Chiemelu D. Emegoakor
    • 1
  • Gabriel U. Chianakwana
    • 1
  • Henry Nzeako
    • 1
  • Eric Ihekwoaba
    • 1
  1. 1.Department of SurgeryNnamdi Azikiwe University Teaching HospitalNnewiNigeria

Personalised recommendations