Impact of chemotherapy on health-related quality of life among ethnically diverse breast cancer survivors treated with breast-conserving therapy.

Abstract

237 Background: Breast cancer (BC) is the most common cancer among women in the U.S. Public awareness and advances in BC screening have resulted in more women being diagnosed with early stage BC and treated with breast-conserving therapy (BCT) (lumpectomy followed by radiation therapy). Depending on prognostic factors and recurrence risk, systemic chemotherapy may be prescribed. Purpose of this study was to examine the impact of chemotherapy on quality of life (QOL) and needs of BC survivors treated with BCT for early stage BC. Methods: A list of 750 breast cancer survivors, aged 18 or older and who completed breast-conservation therapy for stages 0-II from 2001 - 2010, was obtained from a hospital’s tumor registry. Consent form and questionnaires, including a demographic questionnaire, City of Hope’s quality of life survey, and an investigator-developed questionnaire to assess for needs of cancer survivors, were mailed. T-test was used to compare mean subscales and overall QOL scores between those who received chemotherapy and those who did not. Frequencies and percentages were used to summarize the needs of BC survivors. Results: 119 completed surveys were received. Majority of respondents were Asians (56.3%), Caucasians (21.8%) and mixed ethnicity (13.4%). 55 patients received BCT plus systemic chemotherapy and 64 received BCT alone. Those who received systemic chemotherapy scored significantly lower on psychological subscale (p< 0.01), social subscale (p= 0.04), and overall QOL (p= 0.03) compared to survivors treated with BCT alone. Regarding needs, BC survivors want to learn about nutrition (40.3%), pain management (39.5%), improving memory (37.8%), and physical activity (33.6%). Conclusions: Although chemotherapy may decrease the risk of recurrence for early stage BC, lasting effects of treatment can negatively impact QOL. Understanding the impact of chemotherapy on various domains of QOL can be beneficial to patients and healthcare providers when discussing the risks and benefits of adjuvant systemic therapy. Further interventions are needed to improve QOL and address the needs among BC survivors treated with breast-conserving therapy.