Assessing the Quality of Life of Patients with Breast Cancer Treated in a Tertiary Hospital in a Resource-Poor Country
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.
Written informed consent was obtained from patients who participated in this study.
- 3.Ezeome ER (2010) Delays in presentation and treatment of breast cancer in Enugu, Nigeria. Niger J Clin Pract 13:311–316Google Scholar
- 4.Office for National Statistics. Cancer survival in Enland: patients diagnosed between 2010 and 2014 and followed up to 2015. https://www.ons.gov.uk/releases/cancersurvivalforadultsinengland2015. Accessed 18 July 2018
- 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.World Bank. Country profile:world development indicators. http://databank.worldbank.org/data/views/reports/reportwidget.aspx?Report_Name=CountryProfile&Id=b450fd57&tbar=y&dd=y&inf=n&zm=n&country=NGA. Accessed 18 July 2018
- 11.WHO (2015) Current health expenditure as a percentage of gross domestic product (GDP). http://www.who.int/gho/health_financing/health_expenditure/en/. Accessed 18 July 2018
- 12.World Bank. Country profile:world development indicators. http://databank.worldbank.org/data/views/reports/reportwidget.aspx?Report_Name=CountryProfile&Id=b450fd57&tbar=y&dd=y&inf=n&zm=n&country=usa. Accessed 18 July 2018
- 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
- 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.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