Quality Of Life In Breast Cancer Patients Research Articles

Perceived New Normal and Inner Strength on Quality of Life in Breast Cancer Patients Receiving Adjuvant Endocrine Therapy

Objective:This study aimed to investigate the differences in symptom experience, inner strength, adherence, and quality of life (QOL) according to the perception of the new normal, and identify the factors related to the QOL of breast cancer patients undergoing adjuvant hormonal therapy based on the theory of inner strength in women.Methods:This cross-sectional study recruited patients with breast cancer receiving adjuvant hormonal therapy in the National Cancer Center. Demographic and clinical characteristics were recorded, and patients were assessed using the M. D. Anderson Symptom Inventory, Connor-Davidson Resilience Scale 2, Morisky Medication Adherence Scale 8, and Functional Assessment of Cancer Therapy-General Scale.Results:After the breast cancer diagnosis, the perception of the new normal showed a significant dependence on pill count and emotional and functional well-being. The hierarchical regression analysis indicated that the new normal, symptom interference, and inner strength after adjusting for age, time since diagnosis, and receiving chemotherapy were significant predictors of QOL in breast cancer patients receiving adjuvant endocrine therapy. The model accounted for 47.8% of the variance in QOL.Conclusions:The theory of inner strength might be a potential pathway in health care to improve patients' QOL during long-term medication. The results of this study have both theoretical and applied implications. The findings can be utilized as evidence for developing an effective intervention that improves the QOL and adherence to adjuvant hormonal therapy of breast cancer patients.

Post treatment quality of life among Sri Lankan women with breast cancer

BackgroundBreast cancer and its treatment imposes a significant effect in the quality of life (QOL) of women. Being a developing country with contrasting social and cultural norms to the West, Sri Lankan women may have a different experience on QOL following surgical treatment of breast cancer. This study was conducted to evaluate post-treatment QOL in breast cancer patients and to determine its association with the type of surgery.MethodsA cross sectional study was carried out. Fifty four women with non-metastatic breast cancer who underwent surgery for breast cancer at the Professorial Surgical Unit, Colombo during 2015–2018 and completed a minimum of one year follow up after surgery were invited to participate. Fifty-four women who responded were assessed using the validated EORTC QLQ-C30 and QLQ-BR23 questionnaires. Non-parametric tests were used for statistical analyses.ResultsThe mean age was 59 years (range 36–81). A majority (61%, n = 35) underwent mastectomy and the rest (n = 19, 45%) breast conservation surgery (BCS). The mean QLQ-C30 score was 68.8 (range 8.3–100) and the mean scores for physical function, role function, emotional function, cognitive function, and social function were 71.4, 81.5, 77.0, 80.2, and 86.4, respectively. The mean scores for body image, sexual functioning, sexual enjoyment, future perspective, systemic therapy, breast symptoms, arm symptoms, and hair loss assessed by the QLQ-BR23 were 76.4, 18.3, 33.3, 73.6, 30.5, 16.2, 23.4 and 32.7, respectively. No significant differences (P > 0.05) were noted in global health status, physical function, role function, emotional function, cognitive function and social function between BCS and mastectomy. QLQ-BR23 body image, sexual functioning, sexual enjoyment and future perspective also did not differ significantly (p > 0.05) between the two groups.ConclusionsSexual functioning and enjoyment, breast and arm symptoms and hair loss contributed to poor QOL while the impact on global health status including physical, social and emotional functions were minimal. Type of surgery did not appear to be associated with QOL. Future studies with a larger sample sizes will be helpful to further study these factors.

Effects of yoga on health-related quality, physical health and psychological health in women with breast cancer receiving chemotherapy: a systematic review and meta-analysis.

Yoga receive more attention from breast cancer patients, however its feasibility and efficacy during chemotherapy remains conflicting. We performed this systematic review to assess the effects of yoga on health-related quality, physical health and psychological health in breast cancer patients undergoing chemotherapy. A systematic search was conducted to retrieve randomized controlled trials (RCTs) which investigated the comparative efficacy of yoga versus comparators such as usual care among breast cancer patients for health-related quality, physical health and psychological health in PubMed, EMBASE, Cochrane Central Register of Controlled Trials (CNETRAL), Nursing and Allied Health Literature (CINAHL), Chinese Biomedical Literature (CBM) Database, China Science and Technology Journal (CSTJ) Database, China National Knowledge Infrastructure (CNKI), and Wangfang Database from inception to December 2018. The latest search was updated on September 2020. All analyses were completed using RevMan version 5.3. Seven trials involving 693 breast cancer patients met inclusion criteria. Meta-analysis indicated a short-term improvement in fatigue [standard mean difference (SMD), -0.62; 95% confidence interval (CI), -1.17 to -0.07], sleep disturbance (SMD, -0.34; 95% CI, -0.55 to -0.12), depression (SMD, -0.50; 95% CI, -0.70 to -0.31) anxiety (SMD, -0.50; 95% CI, -0.70 to -0.31), and health-related quality of life (QoL) (SMD, 0.72; 95% CI, -0.12 to 1.56) in the yoga group; however beneficial medium- and long-term effects in fatigue, sleep disturbance were not identified. Moreover, qualitative analyses suggested that yoga was not associated with decreased adverse events (AEs) compared with control groups. Yoga may benefit to reduce fatigue, depression and anxiety, improve sleep disturbance, and improve QoL in breast cancer patients receiving chemotherapy in the short-term; however, medium- and long-term effects should be further established owing to limitations.

Emotional state, fatigue, functional status and quality of life in breast cancer: exploring the moderating role of psychological inflexibility

ABSTRACT Previous findings demonstrate that psychological flexibility (PF) might be a protective factor regarding distress in breast cancer patients. Our research aimed to examine the moderating effect of psychological inflexibility (PI) on the relationship between emotional state, fatigue, functional status and quality of life (QOL) in breast cancer. The research was conducted on 64 women (Mage=58.36, SD=11.30) while undergoing radiation therapy. Five moderation analyses were performed with depression, anxiety, stress (Depression Anxiety Stress Scales – 21; DASS-21), fatigue (the Fatigue Assessment Scale Serbian; FAS) and functional status (the Upper Extremity Functional Index; UEFI) as predictors, QOL (Quality of Life Instrument – Breast Cancer Patient Version; QOL-BC) as criterion and PI (Acceptance and Action Questionnaire; AAQ II) as a moderator. The significant moderating effect of PI was obtained in the relationship of QOL with the depression, anxiety, fatigue and functional status. As anxiety, depression, fatigue and functional difficulties decrease, participants who are psychologically flexible report better QOL. On the other hand, psychologically inflexible individuals consistently report impaired QOL, regardless of whether indicators of depression, anxiety, fatigue and diminished functional status are prominent or not. Our findings support the notion that PF may have an important role in the improvement of emotional state and QOL in breast cancer patients. It would be also plausible to assume that interventions aimed at modifying the capacity for PF, might be useful in coping with fatigue and functional complications, which should be explored in future studies.

Abstract P1-17-02: Relationship of lifestyle habits to quality of life of recently diagnosed breast cancer between younger and older women in China

Abstract Background: Breast cancer is the most common cancer among women in China. Hence, how best to live with and improve the quality of life (QOL) of this growing population of women is thus becoming of great public health importance. The aim of the study was to evaluate the relationship of lifestyle habits to QOL among younger and older women who were initially diagnosed with breast cancer within the first two weeks, determine the contribution of lifestyle habits factors on QOL. Methods: A multi-center, hospital-based, case control study was conducted among breast cancer women from 21 hospitals in 11 provinces or municipalities in northern and eastern China from April 2012 to April 2013. The Functional Assessment of Cancer Therapy-Breast Cancer (FACT-B) simplified Chinese version 4 was used to measure QOL. Chi-square test, t-test and Generalized Linear Models were conducted to verify differences in QOL between two groups and to evaluate the contribution of lifestyle habits factors (including smoking, passive smoking, alcohol intake, Tea, Coffee, Sleep satisfaction, Current life satisfaction, Physical activity, BMI) on QOL of breast cancer patients. Results: 1199 eligible breast cancer patients were used for analysis as appropriate. Younger women (age <50 years) at diagnosis of breast cancer appeared to be related to lower scores than older women (age ≥50 years) in QOL subscales including emotional well being (p=0.003), functional well being (p=0.006), breast cancer subscale (p=0.038), and FACT-B Total scores (p=0.028). The relationships of the 9 lifestyle habit items to QOL were different between younger and older women. Firstly, very satisfied to sleep satisfaction and current life satisfaction at diagnosis were associated with higher scores in all the women with breast cancer. Secondly, tea (p=0.009) and alcohol drinking (p=0.001) women showed a significantly higher score in younger age group, while drink coffee (p=0.009) showed a significantly lower score in older age group. Thirdly, compare to the younger age group, often participate in physical activities in older age group was associated with higher QOL overall (p=0.002). And smoking showed worse QOL in the older age group (p=0.045). No other significant items of lifestyle habits were observed associated with FACT-B Total scores. Generalized Linear Models were estimated for the total FACT-B score to identify characteristics that were most strongly associated with these QOL scores. Conclusion: Younger patients (<50 years) showed significantly lower QOL than older patients (≥50 years). Tea and alcohol drinking, very satisfied to sleep satisfaction and current life satisfaction were the strongest predictors of higher QOL in China women when diagnosed with breast cancer at younger age. Meanwhile, no coffee, often participate in physical activities and very satisfied to sleep satisfaction and current life satisfaction were the key predictors of higher QOL in older breast cancer women. Focusing on those predictors may present an especially worthwhile endeavor to enhance the long-term breast cancer survivors’ QOL. The mean scores of the FACT-B Total between two age groupsVariable<50≥50Scores(mean)PScores(mean)PCigarette smoking0.0500.045Yes91.10±17.02977.67±15.080No83.80±16.41885.79±16.894Passive smoking0.0580.722Yes82.59±16.53185.61±16.851No85.67±17.57786.43±18.928Alcohol drinking0.0010.662Yes89.06±19.72986.23±17.958No83.26±15.82085.17±16.834Tea0.0090.053Yes87.22±16.17888.31±18.895No83.21±16.51084.55±16.447Coffee0.0970.009Yes88.81±18.54175.50±10.081No83.77±16.44485.70±17.150Sleep satisfaction0.0010.012Very satisfied89.63±17.63389.69±18.659Satisfied82.67±15.89483.68±15.668Dissatisfied84.89±16.87888.15±18.804Current life satisfaction<0.001<0.001Very satisfied89.10±19.50593.05±20.578Satisfied84.75±15.73586.57±16.390Dissatisfied79.24±15.84077.41±14.562Physical activity0.0550.002Often83.93±17.14589.51±19.928Occasionally85.53±17.02384.97±16.064Never82.01±14.88782.36±14.589BMI (kg/m2) 0.1370.239<24.084.73±16.41785.97±17.51624.0-28.082.25±15.85984.52±15.862>28.084.82±17.04588.41±17.180 Generalized Linear Models ResultsVariableBS.E.95% C.I.walddfPLowerUpper<50Alcohol drinking6.0301.78432.5339.52711.42310.001Tea3.5241.52180.5416.5075.36310.021Very satisfied to Sleep satisfaction4.6042.26340.1689.0404.13710.042Very satisfied to Current life satisfaction9.3762.24594.97413.77817.4291<0.001≥50Coffee-9.4623.6877-16.609-2.2346.58310.010Often participate in physical activities7.1161.97803.23910.99312.9431<0.001Very satisfied to Sleep satisfaction4.0951.96180.2507.9404.35810.037Very satisfied to Current life satisfaction15.4383.26238.95421.74222.1341<0.001 Citation Format: Chao Zheng, Liyuan Liu, Shude Cui, Fuguo Tian, Zhimin Fan, Cuizhi Geng, Xuchen Cao, Zhenlin Yang, Xiang Wang, Hong Liang, Shu Wang, Hongchuan Jiang, Xuening Duan, Haibo Wang, Guolou Li, Qitang Wang, Jianguo Zhang, Feng Jin, Jinhai Tang, Liang Li, Shiguang Zhu, Wenshu Zuo, Fei Wang, Lixiang Yu, Fei Zhou, Yujuan Xiang, Mingming Guo, Yongjiu Wang, Shuya Huang, Zhongbing Ma, Liang Li, Dezong Gao, Qiang Zhang, Qinye Fu, Zhigang Yu. Relationship of lifestyle habits to quality of life of recently diagnosed breast cancer between younger and older women in China [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr P1-17-02.

Abstract P6-14-02: Does immediate breast reconstruction delay oncologic therapy?

Abstract Background: As life expectancy improves in women with breast cancer (BC), all efforts to enhance patients´ quality of life (QOL) have gained great importance. It is known that breast reconstruction (BR) surgery has a big impact in QOL and consequently it has become a valuable element in the multidisciplinary approach of BC patients. It is clear that as long as it does not suppose an interference for their oncologic treatment, patients must have offered immediate breast reconstruction as part of their surgical treatment. However, concerns about delay in oncologic therapy, especially because of postoperative complications may influence oncologic specialists to discourage patients to take this option in certain scenarios. In this study we evaluated the association between immediate BR and delay in time to oncologic treatment (TOT), defined as number of days between surgery and the initiation of oncologic adjuvant therapy (chemotherapy, endocrine and radiotherapy). Methods: IRB approval was obtained for a retrospective review of all patients undergoing BC surgery with immediate BR and received adjuvant oncologic therapy at the National Cancer Institute of Mexico from 2017 to 2019. We performed a 2:1 statistical matching with randomly selected patients from an institutional database who underwent only oncologic surgery and adjuvant therapy using year of surgery (2014-2016) and clinical stage as selection criteria. Demographic, tumor and surgical variables were analyzed in the bivariate analysis. According to the variable TOT, we categorized patients into 3 groups: <20, 20 to 50, and >50 days. We performed a quantile regression to identify the association with delay in TOT. A logistic regression was used to analyze postoperative complications in reconstructed patients as possible risk factors for delay. Results: We analyzed 456 patients undergoing BC surgery, of which 152 (33.3%) underwent immediate BR. Clinical Stage II was the most prevalent in all grousps. Among all patients 60% underwent total mastectomy (TM), 23.5% TM and alloplastic BR, 6.6% TM and autologous BR, 6.6% breast conservative surgery and 3.3% oncoplastic surgery. Patients not reconstructed had a higher median age (53.4 years versus 45.4; p=0.000), higher rates of diabetes (12.5% versus 5.9%; p=0.029) and higher rates of systemic hypertension (23.6% versus 10.5%; p=0.001). In the reconstructed group, the median TOT was 29 days (12 to 179) versus 29.5 days (6 to 188) in the not reconstructed (p=0.43). Among the 21% of reconstructed patients who experienced postoperative complications, we found 16 (10.5%) surgical site infections, 24 (15%) reinterventions, 4 (2.6%) hematoma and 1 (0.65%) flap loss. The complication group did not show delay in the TOT (p=0.09) with a median TOT of 41.5 days. There is a global BR failure rate of 11.8% and it has no association with delay in TOT (p=0.842). Conclusions: In our series, we found a median TOT of 29 days in both groups. There is no difference in TOT between the reconstructed and the not reconstructed groups in terms of delay of TOT. When analyzing the reconstructed group by incidence of postoperative complications, which is one of the main concerns, we also found they did not have a significant impact in delay of therapy. We considered that a multidisciplinary approach, an effective communication between the plastic and the oncologic team and careful patient education are of major importance to get an early detection of complications, prompt management and recanalization of patient to continue their oncologic therapy as planned. Our results support previous findings that breast reconstruction should continue to be encouraged in order to provide good QOL for BC patients without interfering with oncologic outcomes. Citation Format: Juan Enrique Bargallo-Rocha, Daniela Vargas-Salas, Luz M Gutiérrez-Zacarías, Juan Alejandro Torres-Domínguez, Luis Erick Juárez-Cabello, Paula Anel Cabrera-Galeana. Does immediate breast reconstruction delay oncologic therapy? [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr P6-14-02.

The Effect of CoQ10 Supplementation on Quality of Life in Women with Breast Cancer Undergoing Tamoxifen Therapy: A Double-Blind, Placebo-Controlled, Randomized Clinical Trial.

BackgroundSurvival rates among breast cancer patients and the number of patients living with treatment side effects have improved, leading to increased focus on quality of life (QOL). The objective of this study was to determine the efficacy of CoQ10 on QOL scores among breast cancer patients in Iranian undergoing tamoxifen therapy.MethodsThirty breast cancer patients were randomized into two groups. The first group received 100 mg CoQ10, and the second group took fplacebo once a day for 8 weeks. QOL was evaluated by a standard QOL questionnaire and a specific questionnaire on QOL of breast cancer patients at baseline and the end of the study. Also, physical activity of patients was assessed with the IPAQ questionnaire and dietary intake determined by a 3-day dietary record.ResultsThe data of 30 subjects were analyzed. According to QOL C30 data, CoQ10 led to a significant increase in physical functioning (P=0.029), emotional functioning (P=0.031), and cognitive functioning (P=0.023) compared to placebo. Symptom scales revealed a notable reduction in appetite loss in the first group (P=0.01). Global health status showed no significant changes in either study arm. On the QOL BR23, progress in functions and decline in symptoms were not statistically significant. Arm symptoms showed significant reduction (P=0.022) in patients that received placebo.ConclusionThis trial indicates that CoQ10 supplementation has effects in ameliorating some dimensions of QOL in breast cancer patients. To generalize the results, larger and longer intervention studies are needed.Clinical Trial RegistrationIRCT2015042021874N1.

Effectiveness of Yoga on Quality of Life of Breast Cancer Patients Undergoing Chemotherapy: A Randomized Clinical Controlled Study.

Background:Cancer of breast is most common cancer among women in India and vast majority of countries worldwide. While undergoing chemotherapy for carcinoma management, women encounter side effects, which affects their quality of life (QOL). A randomized controlled study with quantitative research approach and time series design was conducted, to study the effectiveness of yoga on QOL of breast cancer patients undergoing chemotherapy.Methodology:One hundred breast cancer patients scheduled for 3-weekly, day-care adjuvant chemotherapy (CEF regimen) were enrolled with consecutive sampling technique, into control (n = 52) and experiment (n = 48) groups, by concealed randomization following written informed consent. Baseline data on QOL were collected before first-cycle chemotherapy using the European Organization for Research and Treatment of Cancer QLQ C30. Patients in the experimental group were taught diaphragmatic breathing techniques, systematic relaxation, and alternate nostril breathing, and Joints and Glands neck and shoulder exercises were instructed to practice twice daily at home. They were supervised in practicing these techniques while they received second, third, fourth, fifth, and sixth cycles of chemotherapy in the day-care facility. Participants in the control group received only routine care. All participants received standard post chemotherapy prescription. Data on QOL were collected from all patients during the second, third, fourth, fifth, and sixth cycles of chemotherapy.Results:The analysis revealed that at the baseline (first chemotherapy cycle), breast cancer patients in control and experimental groups were homogeneous in terms of their sociodemographic and clinical variables and QOL score. Yoga practices were effective in improving the QOL of breast cancer patients in the experimental group in the areas of global health status, physical function, role function, and emotional function and decreasing the symptoms of fatigue, insomnia, loss of appetite, and constipation, during the period of chemotherapy.Conclusion:Yoga practices comprising of relaxation techniques reduce many side effects and improve the QOL of women undergoing chemotherapy for breast cancer.

The Effect of Complementary and Alternative Medicines on Quality of Life in Patients with Breast Cancer: A Systematic Review.

Background:Breast cancer disease and its classic treatment lead to decrease in patients' quality of life (QOL). This systematic review aimed to compare the effectiveness of complementary and alternative medicines (CAMs) categories on the QOL of women with breast cancer.Methods:English clinical trials from PubMed, Emabase, Scupos, and Google Scholar databases were searched electronically by the end of 2018 with the Cochrane Collaboration protocol. Two researchers independently extracted data such as participants' characteristics, CAM methods, QOL assessment tools. CAMs were classified into three categories of dietary supplements, herbal medicine, and mind-body techniques.Results:During the initial search, 1186 articles were found. After reviewing titles, abstracts, and full texts based on inclusion and exclusion criteria, 28 clinical trials were included in the systematic review, 18 of which was randomized controlled trial (RCT). Participants included women with breast cancer who were undergoing the first three phases of breast cancer or postcancer rehabilitation. Among CAM interventions, one article used a dietary supplement, and the other 27 articles included a variety of mind-body techniques. Twenty-seven studies showed improved QOL (P > 0.05).Conclusion:The findings may indicate the potential benefits of CAMs, especially mind-body techniques on QOL in breast cancer patients. Further RCTs or long-term follow-up studies are recommended. Moreover, the use of similar QOL assessment tools allows for more meta-analysis and generalizability of results, especially for the development of clinical guidelines.

Managing Cancer and Living Meaningfully (CALM) Intervention on Chemotherapy-Related Cognitive Impairment in Breast Cancer Survivors.

Objective: To evaluate the effectiveness and feasibility of Managing Cancer and Living Meaningfully (CALM), which is used to reduce chemotherapy-related cognitive impairment (CRCI), relieve psychological distress, and improve quality of life (QOL) in Chinese breast cancer survivors (BCs). Methods: Seventy-four BCs were enrolled in this study. All patients were randomly assigned to either the CALM group or the care as usual (CAU) group. All patients were evaluated by the Functional Assessment of Cancer Therapy–Cognitive Function (FACT-Cog), Distress Thermometer (DT), and the Functional Assessment of Cancer Therapy–Breast (FACT-B) before and after CALM or CAU application to BCs with CRCI. We compared the differences in all these scores between the CALM group and the control group and analyzed the correlation between cognitive function and QOL. Results: Compared with the CAU group, the performance of the CALM group on the FACT-Cog, DT, and FACT-B showed significant differences before and after CALM (t = −18.909, −5.180, −32.421, P = .000, .000, .000, respectively). Finally, there was a positive correlation between cognitive function and QOL in breast cancer patients before (r = 0.579, P = .000) and after (r = 0.797, P = .000) treatment. Conclusions: The present results indicated that CALM has salutary effects on the improvement of cognitive impairment and QOL and relieves psychological distress in breast cancer patients, which may be due to a positive correlation between psychological distress and cognitive function or QOL.

Dynamic Changes Of Body Image And Quality Of Life In Breast Cancer Patients.

PurposeDynamic changes of body image and quality of life (QoL) in breast cancer patients were not commonly investigated. We aimed to compare the dynamic changes in QoL and body image of breast cancer survivors receiving breast-conserving surgery or total mastectomy within 5–10 years after surgery.MethodsPatients with non-metastatic breast cancer who received surgery were invited to complete the World Health Organization Quality of Life–Brief (WHOQOL-BREF) questionnaire and the Body Image Scale (BIS) within 10 years after surgery. We applied kernel smoothing methods to capture the dynamic changes of the patients’ QoL and body image within 5 years after surgery. We also constructed multiple linear regression models to identify predictive factors for QoL and body image.ResultsA total of 581 patients were collected, and 211 of them received breast-conserving surgery. There were no statistically significant differences in QoL and body image for breast-conserving surgery versus total mastectomy, but the former showed fluctuating trends. BIS was a predictor of every item and domain in the WHOQOL-BREF in the multiple linear regression model, and explanatory of the trends of dynamic change over time. Patients without lymph node dissection seemed to have less positive feelings but were more satisfied with sexual activities.ConclusionBody image is predictive of the QoL of breast cancer patients. Dynamic changes of body image and QoL would be useful for shared decision-making regarding surgery in breast cancer patients.

Association Between Performance Status and Quality of Life in Breast Cancer Patients: A Preliminary Study

Abstract Background Cancer patients with low performance status (PS) will have worst survival than patients with good PS. In elderly patients with low PS have lower quality of life (QoL) score. The study between PS and QoL in breast cancer patients is still limited. The purpose of this research is to find correlation between the QoL and PS in breast cancer patients. Method A cross-sectional study was done in our general hospital starting from October 2018 until February 2019. The patients included are those diagnosed with breast cancer and have undergone chemotherapy. QoL is assessed using Breast 23 (BR23) questionnaire which evaluates the functional and symptoms scale of the patient, 0% is the worst function and most symptoms and 100% is the best function and no symptoms. Eastern Cooperative Oncology Group (ECOG) was used to assess the patient´s PS. The ECOG has a scoring system (0-5) which 0 defines as fully active and 5 as dead. The correlation between both variables was analyzed with spearman using SPSS version 24.0. Result From 34 patients with mean age 47.09±9.268, have mean symptoms 55.51±8.36 and mean functional 86.22±11.29. The PS data showed 50% of the patients are fully active. BR23 score mean symptoms 57.1%±9.17% and mean functional 90.78%±8.06% was found in fully active patients. Meanwhile, BR23 score with mean symptoms 53.92%±7.4% and mean functional 81.66%±12.4% was found in patients with restriction (p-value=0.016). Conclusion There is significant association between PS and QoL in breast cancer patients. Fully active patients have better QoL.

Symptoms and QOL in breast cancer patients receiving hormone therapy in Japan.

The aim was to clarify subjective symptoms and quality of life (QOL) in breast cancer patients receiving hormone therapy. After obtaining approval from the research ethics committee, an observational study using a self-administered questionnaire was conducted at outpatient clinical oncology offices in 3 facilities that targeted breast cancer patients under the age of 50 who had been undergoing hormone therapy for less than 1year. The study examined elements such as the breast cancer patients' basic information, symptoms, pain in daily life, QOL, and depression/anxiety. There were 214 valid responses. The respondents had an average age of 43.6. Of them, 100% were also treated with Tamoxifen and 30% with LH-RH agonist. There were 75% who were cognizant of side effects. Difficult symptoms that occurred with high frequency were stiff shoulders/back pain, decreased physical strength, hot flashes, and sweating. Over half the respondents were uncertain as to whether the subjective symptoms were side effects. They lost confidence in their physical strength and felt distressed over weight gain. There were 51 with a HADS anxiety score of 8 or higher, and 46 who scored 8 points or higher for depression. Breast cancer patients undergoing hormone therapy experience a variety of pains, and some also have serious psychological symptoms. Reassessing support systems to examine screening and self-care support is an issue going forward.

A Prospective Longitudinal Study about Change of Sleep, Anxiety, Depression, and Quality of Life in Each Step of Breast Cancer Patients

Purpose: Quality of sleep (QoS), anxiety, depression, and quality of life (QoL) are common issues among breast cancer patients. Prospective longitudinal studies of QoS, anxiety, depression, and QoL in breast cancer patients are lacking. The aim of this study was to find out whether there is a proper treatment point associated with QoS, anxiety, depression, and QoL during early treatment of breast cancer patients. Methods: We used 4 self-report questionnaires about QoS, anxiety, depression, and QoL. QoS was measured using the Pittsburgh Sleep Quality Index, anxiety was measured with the Beck Anxiety Inventory, depression was measured with the Beck Depression Inventory, and QoL was measured with the Quality of Life Enjoyment and Satisfaction Questionnaire-Short Form. Patients were assessed at the time of surgery, at the beginning of chemotherapy, and at the end of chemotherapy. Clinicopathological information was collected for analysis. Results: Fifty-two patients were enrolled in this study, and 29 completed 3 self-report questionnaires. QoS, anxiety, and depression showed no differences during the early treatment period. However, QoL changed during that period (p = 0.004). Type of breast surgery (total mastectomy vs. breast-conserving surgery) showed a relationship with QoS during the entire treatment period, but with anxiety only at the time of surgery (p = 0.002). Although the sample size was too small, the total mastectomy group showed better results. Conclusion: Breast cancer patients experience sleep disturbance, anxiety, depression, and loss of QoL. During the period of treatment, these do not change significantly, but these symptoms are often overlooked. Providing sufficient explanations about the treatment and prognosis of breast cancer and mental support for breast cancer patients prior to treatment will help to improve patients’ QoS, anxiety, depression, and QoL.

The effects of mindfulness meditation and progressive muscle relaxation on fatigue and quality of life in breast cancer patients receiving adjuvant paclitaxel: A three-arm randomized trial.

e12051 Background: Breast cancer patients often suffer from fatigue during adjuvant paclitaxel regimen which frequently impairs quality of life (QOL). Therefore, this three-arm randomized controlled study aimed to examine the effects of mindfulness-based stress reduction (MBSR) and progressive muscle relaxation (PMR) on fatigue and QOL in breast cancer patients receiving adjuvant paclitaxel. Methods: Participants were randomly assigned to either a MBSR (n = 20), (PMR) (n = 19) or control group (CG) (n = 15). Participants in the intervention groups were instructed on MBSR and PGE, the steps of interventions were recorded a voice recorder and a WhatsApp group was designed by the principal investigator. Participants were asked to listen the recorded audio files during exercises. The intervention groups continued MBSR or PMR 20 min. each day, totally 12 weeks at their home. The CG received only an attention placebo education on breast cancer. Data collection tools included Brief Fatigue Inventory (BFI) and Functional Living Index-Cancer (FLIC). Data were collected at three time points: baseline (T1), week 12 (T2), and week 14 (T3) for follow-up assessment. Kruskal Wallis tests was used for data analysis. Results: BFI scores were significantly lower in the MBSR, PMR groups compared with the CG at T2 and at T3 (p < .01). As for FLIC scores, there were no significant differences between the study groups at T2 and at T3 (p > 0.05). Conclusions: A brief, MBSR and PMR initiated concurrently with adjuvant paclitaxel regimen decreased fatigue severity. Based on the results, MBSR and PMR can be recommended as supportive therapies for breast cancer patients receiving adjuvant paclitaxel.

Evaluation of Drug Side Effects Chemotherapy on Quality of Life (QOL) Breast Cancer Patients at Hospital X in Jakarta

Breast cancer is the number one cancer type discovered at women in the world. Most causes are genetic factors and hormonal factors. One cancer treatments with chemotherapy. Chemotherapy drugs active in cells dividing and reproducing, but cells normally to be affected by chemotherapy and side effects from chemotherapy drugs affect quality of life. The aim of the study to evaluate side effects of chemotherapy drugs on the quality of life of breast cancer patients. Sampling technique observational prospective breast cancer patients with completed the chemotherapy cycle from September 2017 to April 2018 with descriptive analysis and statistics by looking correlation between drug side effects and Quality of Life (QoL). Results of the study were side effects of fatigue 100%, nausea 67,5%, vomiting 60%, no appetite 63,75%, fever 42,5%, joint pain 43,75%, diarrhea 16,25%, difficulty swallowing 16,25%, allergies 5%, itching 1,25%, mouth sores 3,75%, swollen right hand 1,25%, constipation 3,75%. QoL results are physical 6,2%; psychology 5,3%; social 4,9%; spiritual 6,8%. Results of Sperman test showed no correlation between the side effects of chemotherapy and QoL P> 0,05. This study shows that there is no relationship between the side effects drug chemotherapy and QoL in breast cancer patients.

Intensity-modulated radiation therapy with simultaneous integrated boost for locally advanced breast cancer: a prospective study on toxicity and quality of life

Radiotherapy after breast conserving surgery and mastectomy with node positive disease has been shown to reduce risk of recurrence and mortality in the treatment of breast cancer. Intensity-modulated radiation therapy (IMRT) after conservative surgery offers several advantages over conventional RT including improved acute and late toxicity and quality of life (QoL). We undertook this study to prospectively evaluate acute (≤90 days after last dose of radiotherapy) and long-term (>90 days) cutaneous, esophageal, and fibrosis toxicity and QoL in breast cancer patients treated by adjuvant IMRT after breast surgery. We included patients with complex volumes for which 3D RT does not allow a good coverage of target volumes and sparing organs at risk. We report here an interim analysis with a median follow-up of 13.1 months (range, 6.5–25.9 months). Most of the acute toxicity was cutaneous (95.9%) and oesophageal (59.6%), and mostly grade 1 and 2. Medium-term cutaneous toxicity rate was 25.6%, and mostly grade 1. Medium-term esophageal toxicity was rare (1.8%). In this series acute oesophageal toxicity was found to be associated with dosimetric factors. QoL was well preserved throughout the study, and aesthetic outcomes were good. Based on these data, tomotherapy may be a favorable alternative to other techniques in patients needing a complex irradiation of the breast and lymph node volumes.

The role of depression in the relationship between cognitive decline and quality of life among breast cancer patients.

Cancer patients who underwent chemotherapy experience cognitive decline, which, in turn, negatively impacts quality of life (QoL). Depression is considered a psychological factor that is negatively associated with the QoL of cancer patients. However, the relationships among cognitive functioning, depression, and QoL in breast cancer patients are under-researched in the literature. The aim of this cross-sectional study was to identify the role of depression in the relationship between cognitive functioning and QoL among breast cancer patients. One hundred thirty breast cancer patients who underwent primary treatment participated. Participants completed the Functional Assessment of Cancer Therapy-Cognitive Function version 3, the Montreal Cognitive Assessment, the Beck Depression Inventory-II, and the Functional Assessment of Cancer Therapy-Breast Scale. The data were analyzed using multiple regression according to Baron and Kenny's strategies and the Sobel test. Subjective and objective cognitive functioning and depression were statistically significant predictors of QoL in breast cancer patients. Depression played a partial mediating role in the relationship between objective cognitive functioning and QoL and between subjective cognitive functioning and QoL. Additionally, the Sobel test demonstrated that depression had a significant partial mediating effect between subjective cognitive functioning and QoL (Z = 4.91, p < 0.001) and between objective cognitive functioning and QoL (Z = 2.62, p = 0.009). The findings indicated that depression could influence the association between cognitive functioning and QoL in breast cancer patients. Healthcare providers should develop an intervention focused on decreasing depression to evaluate the effectiveness of improving quality of life for breast cancer patients with cognitive dysfunction.

Variability and Influencing Factors of QOL in Breast Cancer Patients Having Chemotherapy.

Variability and factors influencing quality of life (QOL) in breast cancer patients having chemotherapy were examined in a longitudinal prospective cohort study in two teaching hospitals in China. Physical, mental, social/family, and functional QOL changed significantly over time with varying patterns. In addition, various factors influenced the QOL of breast cancer patients at each chemotherapy cycle. Health professionals should focus on critical time periods during chemotherapy, particularly at baseline and during the fourth and fifth cycles when the QOL in our sample was at the lowest point, and they should provide additional support to patients to ensure that chemotherapy is delivered in an optimal fashion.

Assessing the Quality of Life of Patients with Breast Cancer Treated in a Tertiary Hospital in a Resource-Poor Country.

Very few studies have assessed the quality of life (QoL) of patients living with breast cancer in a resource-poor setting like Nigeria. The aim of our study was to comprehensively examine the measures of QoL in breast cancer patients using the Functional Assessment of Cancer Therapy-Breast (FACT-B) version 4 in order to deepen the literature on QoL among breast cancer patients to include non-Western/northern patient populations. Purposive sampling of stable patients who attended general surgery clinics with histopathologically diagnosed breast cancer was done. Eligible patients were assessed using five domains of the FACT-B questionnaire including: the breast cancer-specific symptoms (BCS), emotional well-being (EWB), functional well-being (FWB), physical well-being (PWB), and social & family well-being (SWB). The questionnaire was administered in a face-to-face interview by trained research assistants. In addition, the five domains were compared among three different age categories, pre-menopausal and post-menopausal, and patients who have had surgery and chemotherapy alone. The SPSS (IBM Corp. Released in 2011. IBM SPSS Statistics for Windows, Version 20.0. Armonk, NY: IBM Corp.) and the Microsoft Excel (11. Corporation Microsoft, Redmond, WA, USA) were used for statistical analysis. Statistical significance was inferred when p <0.05. Among the 60 enrolled participants, total score of the five domains (n = 144) was 74.59 ± 17.72, FACT-G score (n = 108) was 53.49 ± 12.56, Trial outcome index (n = 112) was 49.20 ± 13.13, PWB (n = 28) was 10.95 ± 6.37, SWB (n = 28) was 18.41 ± 6.48, EWB (n = 24) was 6.98 ± 4.15, FWB (n = 28) was 17.15 ± 7.12, and the BCS (n = 36) was 21.10 ± 8.93. EWB was significantly less in post-mastectomy patients on adjuvant chemotherapy (p = 0.031) and pre-menopausal women (p = 0.041) as well as in patients less than 40years when compared with patients more 50years (p = 0.049). Breast cancer patients in resource-poor countries have a profoundly impaired quality of life. This study showed significantly lower emotional well-being domain scores in post-mastectomy patients on adjuvant chemotherapy, pre-menopausal women having breast cancer and in younger female patients. There is need to address this anomaly.