Breast cancer Survivors - Physical and Mental Quality of Life 10 Years Following Diagnosis -

Angela Chetrit ¹ Sivan Ben-Avraham Shulman ¹ Lori Mandelzweig ¹ Tova Amitai ¹ Nava Siegelmann Danieli ² Siegal Sadetzki ^3,4

¹Cancer & Radiation Epidemiology Unit, Gertner Institute for Epidemiology & Health Policy Research, Chaim Sheba Medical Center, Israel
²Oncology service line Department of Professional medicine, Maccabi Health Services, Tel Aviv, Israel
³Sackler Faculty of Medicine,, Tel Aviv University, Tel Aviv, Israel
⁴Public Health Service, Ministry of Health, Israel

Background: Significant improvements in diagnosis and treatment of BC have resulted in an increase in the life expectancy of the survivors. Consequentially, a concern was raised regarding the health & well-being of this growing population. Quality of life (QOL) which is accepted as a multidimensional construct of physical, psychological and social functioning has become an important issue in BC survivorship care.

Aim: To assess the QOL of BC survivors, 10 years following diagnosis, compared to a comparison group with no history of cancer.

Methods: The study participants lived in central Israel and were members of Maccabi Healthcare Services. The case group included 250 women who were diagnosed with BC between 1999-2003, and had no cancer history prior to BC diagnosis and no evidence of the disease after 8-12 years. The comparison group included 250 women with no cancer history, individually matched to cases by age and geographic area of residence. QOL was assessed using the Short Form-36 (SF-36) questionnaire. Regression analyses were performed evaluating the influence of demographic, socioeconomic, life-style characteristics and number of co-morbidities on physical and mental health QOL.

Results: Compared to controls, BC survivors reported significantly lower scores of the eight multi-item scales of QOL except for social functioning and mental health. The mean scores of the two summary measures, physical and mental health QOL were 66.8+23.4 and 71.9+18.5 compared to 72.7+21.8 and 75.6+17.5, in survivors and controls respectively (p=0.004 and p=0.02). A negative association was seen between number of co-morbidities and QOL scores. Controlling for age, income, number of co-morbidities, BMI and physical activity, being a BC survivor decreased the physical and mental scores by 5 and 3 points, p=0.002 and 0.04, respectively.

Conclusions: QOL of BC survivorship has become an important health care concern that should gain more attention in the area of cancer care.