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Breast Cancer Research and Treatment

, Volume 98, Issue 3, pp 275–284 | Cite as

Chemotherapy versus ovarian ablation as adjuvant therapy for breast cancer: impact on health-related quality of life in a randomized trial

  • Mogens Groenvold
  • Peter M. Fayers
  • Morten Aagaard Petersen
  • Henning T. Mouridsen
Clinical trial

Summary

Background

Ovarian ablation is an effective adjuvant therapy for primary breast cancer but little is known about its quality of life impact relative to the more widely used adjuvant chemotherapy. This randomized study compared quality of life outcomes of adjuvant ovarian ablation versus cyclophosphamide, methotrexate, fluoracil (CMF) chemotherapy.

Methods

The Danish Breast Cancer Cooperative Group (DBCG) trial 89-b randomized premenopausal patients with receptor-positive, primary breast cancer between nine cycles of CMF chemotherapy given every 3 weeks and ovarian ablation by oophorectomy. In total, 317 randomized patients were invited to take part in a longitudinal quality of life study with assessments at 1, 3, 5, 9, 15, and 24 months after randomization. The questionnaire included the EORTC QLQ-C30, the Hospital Anxiety and Depression Scale, and additional items assessing potential symptoms not included in the standard instruments.

Results

After 2 years, 260 women were alive and recurrence-free, and 196 of these (75%) had completed all six questionnaires. Overall, patients in the chemotherapy group had more symptomatology at the first three assessments (i.e., during the 6 months treatment period), except for hot flushes/sweats. There were few differences between groups at later assessments. In chemotherapy patients, the likelihood of preserving ovarian function decreased steeply with increasing age. CMF chemotherapy and ovarian ablation have similar impact on recurrence and survival.

Conclusion

Chemotherapy had more negative impact on health-related quality of life but preserved ovarian function in some younger patients.

Keywords

breast neoplasms chemotherapy outcomes ovarian ablation quality of life randomized trial 

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Notes

Acknowledgement

Supported by the Danish Cancer Society (Grants 91-505 and 94 150 01).

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Copyright information

© Springer Science+Business Media, Inc. 2006

Authors and Affiliations

  • Mogens Groenvold
    • 1
    • 2
    • 6
  • Peter M. Fayers
    • 3
    • 4
  • Morten Aagaard Petersen
    • 1
  • Henning T. Mouridsen
    • 5
  1. 1.The Research Unit, Department of Palliative MedicineBispebjerg HospitalCopenhagenDenmark
  2. 2.Department of Health Services Research, Institute of Public HealthUniversity of CopenhagenCopenhagenDenmark
  3. 3.Department of Public HealthUniversity of Aberdeen Medical SchoolAberdeenUK
  4. 4.Unit for Applied Clinical ResearchNorwegian University of Science and TechnologyTrondheimNorway
  5. 5.Department of Oncology ONK, The Finsen Center, RigshospitaletUniversity of CopenhagenCopenhagenDenmark
  6. 6.The Research Unit, Department of Palliative MedicineBispebjerg HospitalCopenhagenDenmark

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