Association of young age and chemotherapy with psychosocial distress and health-related quality of life (HRQOL) during the first year after breast cancer (BC)

Abstract

8014 Background: Psychosocial distress and HRQOL after BC diagnosis may be related to a variety of factors, including age and treatment. Methods: We investigated these attributes in 397 women with newly diagnosed T1–3, N0–1, M0 BC. Women completed the Profile of Mood States (POMS), Impact of Event Scale (IES), Psychosocial Adjustment to Illness Scale (PAIS), Mental Adjustment to Cancer Scale (MAC) and EORTC QLQ-C30 questionnaires shortly after diagnosis (9.7±5.2 weeks) and one year post diagnosis (57.4±7.7 weeks). The impact of age and adjuvant chemotherapy was analysed with t-tests and regression analysis. Mean age was 52.0±9.9 years. 47.6% were postmenopausal, 68.0% had ER/PgR positive tumors, 39.8% received CXT, 44.0% tamoxifen. Results: At baseline, young age was significantly associated with greater distress (POMS all scales, total score), greater adverse impact on adjustment (PAIS 4 subscales, total), greater anxious-preoccupied and reduced fatalistic coping (MAC), and reduced emotional and cognitive functioning (EORTC QLQ-C30) (all p≤0.05); most of these effects were attenuated at one year, reflecting improvement over time. At 1 year, anxiety, anger and total mood disturbance (POMS), psychological distress and total score (PAIS), poor emotional functioning (EORTC QLQ-C30), and greater anxious-preoccupied coping and fatalistic coping (MAC) remained significantly associated with young age (p≤0.05). Physical functioning (EORTC QLQ-C30) was worse in older women at both timepoints. Adjusting for age, women who received chemotherapy reported greater adverse impact on vocational and social functioning (PAIS); role, social functioning and QOL (EORTC QLQ-C30) at baseline (p≤0.05). At one year, greater adverse impact of chemotherapy was seen for most PAIS scales and for physical, role and social functioning (EORTC QLQ-C30) (p≤0.05). Conclusions: Age is an important determinant of psychosocial distress and HRQOL in newly diagnosed BC; women who receive CXT report greater adverse impact on adjustment, role, social and vocational functioning which persisted at one year. No significant financial relationships to disclose.