Critical Review of Quality of Life: Psychosocial Aspects of Adjuvant Therapy in Breast Cancer

Abstract

Adjuvant treatment of breast cancer is considered primarily a medical problem. At first glance, the psychosocial sciences have little to contribute. Treatment evaluation focusses on the biological and clinical behavior of the tumor. The conventional end points of adjuvant trials are disease-free survival (DFS) and overall survival (OS). In the early days of chemotherapy, Karnofsky and Burchenal (1949) proposed “mood” and “the general feeling of well-being” as subjective criteria of improvement in addition to the physical performance status. In the following years, while new developments made chemotherapy more effective, these criteria of subjective improvement were lost. In recent years, the psychological and social implications of primary breast cancer treatments have been of growing scientific interest. Initial attempts have been made to integrate the subjective experience of the patient into treatment evaluation (Fig. 1).