Abstract

PurposeQuality of life (QoL) plays an important role in recovery—especially after an incisive diagnosis such as breast cancer. Here, we present a comprehensive assessment of QoL for pre- and postmenopausal patients, starting from initial systemic treatment of early breast cancer until 3 years later, in patients from a so-called “real-world” setting.Methods251 premenopausal and 478 postmenopausal patients with early breast cancer have been recruited into the longitudinal MaLife project within the prospective, multicentre, German Tumour Registry Breast Cancer between 2011 and 2015. The questionnaires FACT-G, FACT-Taxane, FACT-ES, EORTC QLQ-BR23, BFI and HADS were filled in at start of treatment (T0), 6, 12, 24 and 36 months later. The proportion of patients with clinically meaningful changes at 36 months was determined.ResultsThis first interim analysis shows that the FACT-G global QoL improved over time regardless of the menopausal status. However, clinically meaningful decrease of social/family well-being (48–51%), arm symptoms (44–49%) and symptoms of neurotoxicity (55–56%) was frequently reported 3 years after start of treatment. Many premenopausal patients also reported a clinically meaningful worsening of endocrine symptoms (64%), emotional well-being (36%) and fatigue intensity (37%). Additionally, 3 years after start of treatment, 15% of the patients were classified as doubtful cases and 18% as definite cases of anxiety.ConclusionsDespite improvements in global QoL, breast cancer survivors report worsened ailments 3 years after start of therapy. Follow-up care should distinguish between premenopausal patients needing special attention for emotional/menopausal issues, and postmenopausal patients needing particular care regarding physical concerns.

Highlights

  • Breast cancer remains the most frequent cancer among women, with approximately 266,000 estimated new cases in the US and 72,000 in Germany in 2018 [1, 2]

  • In patients with early breast cancer, standard of care is the surgical removal of the tumour, preceded or followed by chemotherapy, and/or preceded by radiation therapy depending on the individual risk profile of the patient

  • Treatment with either tamoxifen or aromatase inhibitors should last for at least 5 years, the patients have to deal with a long period of medical interventions, potential side effects and the associated psychological strain, all of which can strongly affect the quality of life (QoL) [5,6,7]

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Summary

Introduction

Breast cancer remains the most frequent cancer among women, with approximately 266,000 estimated new cases in the US and 72,000 in Germany in 2018 [1, 2]. With a 5-year survival rate of almost 90%, there is a growing number of breast cancer survivors in need of optimal care [1, 2]. In patients with early breast cancer, standard of care is the surgical removal of the tumour, preceded or followed by chemotherapy, and/or preceded by radiation therapy depending on the individual risk profile of the patient. The majority (approximately 75%) of breast cancer cases are hormone receptor-positive (HR-positive) tumours [3] for whom additional adjuvant endocrine treatment is recommended. Treatment with either tamoxifen or aromatase inhibitors should last for at least 5 years, the patients have to deal with a long period of medical interventions, potential side effects and the associated psychological strain, all of which can strongly affect the quality of life (QoL) [5,6,7]

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