Quality of life and breast cancer – state of the art

Abstract

The quality of life (QoL) impairments of patients receiving a diagnosis and treatment of breast cancer can be substantial. These include early menopause, chemotherapy induced toxicity, loss of body image, limitations of sexual activity and fertility. When assessing the value of a particular anticancer treatment, it is important to consider the impact it may have not only on survival but also on QoL. In clinical trials, the standard endpoints are response rates, progression free survival, overall survival, and toxicity. In recent years, QoL has become an additional secondary trial endpoint. The current state of evaluating the QoL of breast cancer patients, employ a multidimensional approach involving validated self-reported questionnaires. Among the QoL instruments, there are some measures specifically developed for breast cancer such as the European Organisation for Research and Treatment (EORTC) BR-23 module. Up to now, several randomized EORTC trials have evaluated QoL using the EORTC QLQ-BR23 module. Results from randomized clinical breast cancer trials in which two treatments of comparable efficacy could be evaluated and chosen on the basis of their impact on QoL parameters is important to clinical decision-making. After a general Introduction: to the conceptualisation of QoL, methodological issues, measurements specific for breast cancer and guidelines for assessing QoL in clinical trials will be presented. Aspects affecting the QoL of breast cancer patient in relation to different treatment regimens will be discussed.