Abstract
BackgroundThe diagnosis of breast cancer and its subsequent treatment has significant impact on the woman's physical functioning, mental health and her well-being, and thereby causes substantial disruption to quality of life (QOL). Factors like patient education, spousal support and employment status, financial stability etc., have been found to influence QOL in the breast cancer patient. The present study attempts to identify the determinants of QOL in a cohort of Indian breast cancer patients.Patients and methodsFunctional Assessment of Cancer Therapy-Breast (FACT-B) Version 4 Malayalam was used to assess quality of life in 502 breast cancer patients undergoing treatment with curative intent. The data on social, demographic, disease, treatment, and follow-up were collected from case records. Data was analysed using Analysis of Variance (ANOVA) and multinomial logistic regression.ResultsThe mean age of the patients was 47.7 years with 44.6% of the women being pre-menopausal. The FACT-B mean score was 90.6 (Standard Deviation [SD] = 18.4). The mean scores of the subscales were – Physical well-being 19.6 (SD = 4.7), Social well-being 19.9 (SD = 5.3), Emotional well-being 14 (SD = 4.9), Functional well-being 13.0 (SD = 5.7), and the Breast subscale 23.8 (SD = 4.4). Younger women (<45 years), women having unmarried children, nodal and/or metastatic disease, and those currently undergoing active treatment showed significantly poorer QOL scores in the univariate analysis. However multivariate analysis indicated that the religion, stage, pain, spouse education, nodal status, and distance travelled to reach the treatment centre as indicative of patient QOL.ConclusionQOL derangements are common in breast cancer patients necessitating the provisions for patient access to psychosocial services. However, because of the huge patient load, a screening process to identify those meriting intervention over the general population would be a viable solution.
Highlights
The diagnosis of breast cancer and its subsequent treatment has significant impact on the woman's physical functioning, mental health and her well-being, and thereby causes substantial disruption to quality of life (QOL)
In India it shows mix incidence pattern with breast cancer being second to cancer of the cervix in rural areas [1,2], in metropolitan cities like Mumbai, New Delhi and Trivandrum, the incidence of breast cancer has crossed that of cervix
In absence of screening programmes, majority of the breast cancers are still diagnosed in locally advanced stage and achieving longer survival is still a priority
Summary
The diagnosis of breast cancer and its subsequent treatment has significant impact on the woman's physical functioning, mental health and her well-being, and thereby causes substantial disruption to quality of life (QOL). Spousal support and employment status, financial stability etc., have been found to influence QOL in the breast cancer patient. The focus of breast cancer care, in addition to examining short-term treatment related quality of life (QOL) outcomes, has expanded to include acute treatment-related side effects and long-term factors that influence the quality as well as quantity of survival [4,5,6,7]. A few studies on QOL in the Indian context exist, factors like patient education, spousal support and employment status, financial stability, disease stage, etc., have been found to influence patient QOL [8,9]
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