Gesundheitswesen 2017; 79(08/09): 656-804
DOI: 10.1055/s-0037-1605831
Vorträge
Georg Thieme Verlag KG Stuttgart · New York

Quality of life over time in a German cohort of breast cancer survivors

K Thöne
1   University Cancer Center Hamburg, University Medical Center Hamburg-Eppendorf (UKE), Department of Cancer Epidemiology, Hamburg
,
N Obi
2   University Medical Center Hamburg-Eppendorf (UKE), Department of Medical Biometry and Epidemiology, Hamburg
,
A Jung
3   German Cancer Research Center (DKFZ), Division of Cancer Epidemiology, Heidelberg
,
M Schmidt
4   German Cancer Research Center (DKFZ), Division of Physical Activity, Prevention and Cancer, Heidelberg
,
J Chang-Claude
3   German Cancer Research Center (DKFZ), Division of Cancer Epidemiology, Heidelberg
5   University Cancer Center Hamburg, University Medical Center Hamburg-Eppendorf (UKE), Genetic Tumour Epidemiology Group, Hamburg
,
D Flesch-Janys
1   University Cancer Center Hamburg, University Medical Center Hamburg-Eppendorf (UKE), Department of Cancer Epidemiology, Hamburg
2   University Medical Center Hamburg-Eppendorf (UKE), Department of Medical Biometry and Epidemiology, Hamburg
› Author Affiliations
Further Information

Publication History

Publication Date:
01 September 2017 (online)

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Background:

Breast cancer (BC) survivors often suffer late and long-term residual symptoms from the disease and its treatment. To date, relatively little is known about long-term quality of life (QoL) in BC survivors. This study aimed to investigate QoL over time using patient reported status before diagnosis (T0), during treatment phases (T1), as well as 1 year post-surgery (T2), approx. 5 years (T3) and ≥10 years (T4) post-diagnosis.

Methods:

Data from the German population-based MARIE cohort of 3813 BC patients aged 50 – 74 years at diagnosis (2002 – 2005) and followed up until 2009 (1FUP) and 2015 (2FUP) were used for analysis. QoL was assessed with the EORTC QLQ-C30 questionnaire linearly transformed to a 0 – 100 points scale. Differences in QoL were investigated via t-tests for paired samples or Wilcoxon signed-rank test for nonparametric distributions and effect sizes were calculated following Cohen.

Results:

A total of 1223 patients fulfilled the inclusion criteria (participation at all three time points, early stage invasive breast cancer (I-IIIa) with no prior malignant tumor). Median follow-up was 11.7 years (standard deviation (SD) 1.2). Overall QoL was highest at T0 and lowest during chemotherapy (T1) (Mean (M)= 77.3, SD = 27.6 vs. M = 30.9, SD = 27.2; t(532)= 26.7, p =< 0.001). QoL increased afterwards from T2 to T3 (M = 57.2, SD = 26.6 vs. M = 68.4, SD = 22.4; t =-15.9, p =< 0.001) but decreased until T4 (M = 63.7, SD = 24.8; t = 6.2, p =< 0.001; d = 0.19) for all age groups. While younger patients (50 – 58 years) reported statistically significant better physical, emotional, cognitive, role and social functioning, older patients reported similar or poorer QoL with longer time since diagnosis (T3 vs. T4).

Conclusion:

For all age groups we found largest deterioration of QoL during treatment phase. Particularly older patients appear to suffer from decreasing QoL in the long-term post-diagnosis. Efforts to improve acute and long-term quality of care or interventions seem to be worthwhile.