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Quality of Life in Breast Cancer Patients: An Overview of the Literature

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Handbook of Disease Burdens and Quality of Life Measures

Abstract:

Quality of life in patients with breast cancer is an important outcome. This chapter presents an overview of the literature on the topic ranging from descriptive findings to clinical trials. There is quite an extensive body of the literature on quality of life in breast cancer patients. Studies on quality of life in breast cancer have made a considerable contribution in improving breast cancer care, although their exact benefit is hard to define. Quality of life data in breast cancer patients provided scientific evidence for clinical decision-making and conveyed helpful information concerning breast cancer patients’ experiences during the course of the disease diagnosis, treatment, disease-free survival time, and recurrences; otherwise finding solutions for evidence-based selection of optimal treatments, psychosocial interventions, patient–physician communications, allocation of resources, and indicating research priorities were impossible. More qualitative research is needed for a better understanding of the topic. In addition, issues related to the disease, its treatment side effects and symptoms, and sexual functioning should receive more attention when studying quality of life in breast cancer patients.

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Abbreviations

A:

doxorubcin

ALND:

axillary lymph node dissection

ANA:

anastrozole

BCPT-BESS:

breast cancer prevention trial eight symptom scale

BCPT-SCL:

BCPT symptom checklist

BCQ:

breast cancer chemotherapy questionnaire

BCS:

breast conservation surgery

BI:

body image

BIBCQ:

body image after breast cancer questionnaire

C:

cyclophosphamide

CTCb:

cyclophosphamide, thiotepa, and carboplatin

DPPE:

tesmilifene

E:

epirubcin

EORTC QLQ-BR23:

European Organization for Research and Treatment of Cancer breast cancer specific quality of life questionnaire

EXE:

exemestane

F:

5-fluorouracil

FACT-B:

functional assessment of cancer therapy breast cancer specific questionnaire

FACT-B+4:

impact of arm morbidity subscale for FACT-B

FACT-B-plus ES:

an endocrine symptom subscale for the FACT-B

FACT-G:

functional assessment of cancer therapy-general

FSAQ:

Fallowfield’s sexual activity questionnaire

FU:

future perspective

G-CSF:

granulocyte colony stimulating factor

HADS:

hospital anxiety and depression scale

LASA:

linear analogue self-assessment

LSQ-32:

life satisfaction questionnaire

M:

methotrexate

MAS:

mastectomy

MRM:

modified radical mastectomy

PTSD:

post-traumatic distress disorder

QLACS:

quality of life in adult cancer survivors

QOL:

quality of life

RSC:

Rotterdam symptom checklist

SEE:

sexual enjoyment

SEF:

sexual functioning

SF-36:

medical outcomes study short form survey

SLDS-BC:

satisfaction with life domains scale for breast cancer

SNLB:

sentinel lymph node biopsy

T:

docetaxel

TAM:

tamoxifen

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Author information

Authors and Affiliations

  1. Professor in Public Health and Epidemiology, Iranian Institute for Health Sciences Research (IHSR), Tehran, Iran

    A. Montazeri

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  1. A. Montazeri
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Editors and Affiliations

  1. Dept. Nutrition and Dietetics Nutritional Sciences Research Division School of Biomedical & Health Sciences, King's College London, Franklin‐Wilkins Building 150 Stamford Street, SE1 9NH, London, UK

    Victor R. Preedy (Prof.) (Prof.)

  2. Mel and Enid Zuckerman College of Public Health, University of Arizona, Health Science Center 1295 N. Martin, P.O. Box 245155, 85724-5155, Tucson, AZ

    Ronald R. Watson (Prof.) (Prof.)

Appendix

Appendix

1.1 Some Key Facts About Breast Cancer

  • The most common sign of breast cancer is a new lump or mass. A lump that is painless, hard, and has uneven edges is more likely to be cancer. Sometimes cancers can be tender, soft, and rounded. Other signs of breast cancer include a swelling of part of the breast; skin irritation or dimpling; nipple pain or the nipple turning inward; redness or scaliness of the nipple or breast skin; a nipple discharge (other than breast milk); and a lump in the under arm area.

  • The cause of breast cancer is not known. Factors that can increase a woman’s risk include heredity, early puberty, late childbearing, obesity, and lifestyle factors such as heavy alcohol consumption and smoking. The biggest risk factor for breast cancer is age that is growing older. Most breast cancers occur in women over the age of 50, and women over 60 are at the highest risk.

  • A woman’s risk for developing breast cancer increases if her mother, sister, daughter, or two or more other close relatives, such as cousins, have a history of breast cancer, especially at a young age. However, 85% of women who develop breast cancer have no known family history of the disease.

  • Changes in certain genes (BRCA1, BRCA2, and others) make women more susceptible to breast cancer. Genetic testing can determine whether a woman has these abnormal genes.

  • Based on involvement of breasts, breast cancer can be categorized as stage 0 (cancer cells remain in the breast duct), stage I (cancer is 2 cmentimeters or less), stage II (tumor is over 2 but not larger than 5 cm or is spread to the lymph nodes under the arm), stage III or locally advanced (tumor is more than 5 cm or is extensive in the under arm lymph nodes or spread to other lymph nodes or tissues near the breast) and stage IV (cancer has spread or metastasized to other parts of the body).

  • 5-year survival time for breast cancer patients vary depending on stage and treatment received. However, there are differences between survival for the same breast cancer patients in developed and developing countries.

Source: adapted from www.breastcancer.org

1.2 Breast Cancer Treatment Options

  • Surgery is the treatment of choice for breast cancer. There are different surgery options for breast cancer: breast conservation surgery and mastectomy.

  • In breast conservation surgery we save the breast and it includes: lumpectomy (malignant tumor and a rim of normal tissue are removed) or quadrantectomy (malignant tumor and a large rim of normal tissue are removed) with axillary dissection.

  • In mastectomy the whole breast is removed and it includes: total or simple mastectomy (whole breast is removed); or modified radical mastectomy (the whole breast is removed with under arm lymph nodes); or radical mastectomy (the whole breast, chest muscles, all lymph nodes under the arm, and some additional fat and skin are removed).

  • Chemotherapy uses drugs to destroy cancer cells. It is given systemically (throughout the body) after surgery to kill cancer cells that may have been left behind (adjuvant therapy). Also it may be given before surgery to reduce the size of the cancer (neoadjuvant therapy).

  • Hormonal therapy is a form of whole body (systemic) treatment for breast cancer. In hormonal therapy, drugs are used to reduce or block the effects of hormones (including estrogen and progesterone) that can promote the growth of breast cancer. Hormonal therapy protects the whole body from breast cancer cells that may have been left behind after surgery, radiation, or chemotherapy. It can also lower the risk of a new cancer developing in the other breast.

Source: adapted from www.breastcancer.org

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Montazeri, A. (2010). Quality of Life in Breast Cancer Patients: An Overview of the Literature. In: Preedy, V.R., Watson, R.R. (eds) Handbook of Disease Burdens and Quality of Life Measures. Springer, New York, NY. https://doi.org/10.1007/978-0-387-78665-0_165

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  • DOI: https://doi.org/10.1007/978-0-387-78665-0_165

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