Health-related quality of life during adjuvant radiotherapy in breast cancer

Abstract

In this study, health- related quality of life (HRQoL) and its determinants were assessed in breast cancer patients undergoing postoperative adjuvant radiotherapy. The aim was to improve our understanding of patient's situation at the end of adjuvant treatment, as the return to every day life approaches after breast cancer surgery and adjuvant chemo- and radiotherapy. Health- related quality of life was measured by the 15D instrument. Self-administered questionnaires were distributed to patients undergoing postoperative radiotherapy. Out of 389 consecutive breast cancer patients, 273 comprised the final study group. The results were compared to 15D results for an age-standardized sample of the female general population in Finland (n = 3,335). Determinants of HRQoL were assessed by a multivariate model. In patients <53 years, but not in older patients, the total 15D score was lower than in age-standardized controls. Both younger and older patients differed significantly from the controls on specific 15D dimensions of sleeping, depression, distress, vitality, and sexual activity. When clinical and treatment variables were assessed by a multivariate model, depressive symptoms had a negative effect on HRQoL. Further, having undergone breast conserving surgery instead of mastectomy was associated with poorer HRQoL. Impairment of HRQoL was observed during adjuvant radiotherapy in breast cancer. This finding calls for action to develop supportive and preventive means to smoothen the return to normal activities after completion of adjuvant treatment for breast cancer.