Abstract
Prospective longitudinal health-related quality of life (QOL) data from 161 women newly diagnosed with breast cancer were compared to age-adjusted mean QOL scores from a general female population (n=949). In addition, multiple factors (demographic, personality trait, participation in treatment decision-making, information satisfaction, and medical data), which previous research has indicated affect the QOL of breast cancer patients, were simultaneously investigated in a multivariate model, in order to determine which of these variables have the strongest influence on QOL one year after surgery. QOL was evaluated with the EORTC QLQ-C30 at time of diagnosis, three- and 12-months postoperatively. Women with breast cancer scored significantly lower on emotional, cognitive, and social functioning (p < 0.01) at time of diagnosis compared to the general female population, and continued to score lower on cognitive (p=0.008) and social (p=0.009) functioning one-year after surgery. In addition to the initial QOL, breast conservation surgery was predictive of better physical functioning (p=0.01) and body image (p < 0.0001), while chemotherapy was predictive for poorer role functioning (p=0.01) one year after surgery. Dispositional optimism was predictive for better emotional (p=0.003) and social functioning (p=0.01) one year after surgery. At time of diagnosis and throughout the post-diagnosis period, dispositional optimism was associated with better QOL and fewer symptoms.
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Scheier MF, Carver CS, Bridges MW. Optimism, pessimism, and psychological well-being. In Chang EC, ed. Optimism and Pessimism, Washington: American Psychological Association. 2001; 189–216.
Fayers PM, Machin D. Quality of Life. Assessment, Analysis and Interpretation, West Sussex: Wiley & Sons Ltd, 2000.
CS Carver JM Lehman MH Antoni (2003) ArticleTitleDispositional pessimism predicts illness-related disruption of social and recreational activities among breast cancer patients J Pers Soc Psychol 84 IssueID4 813–821 Occurrence Handle10.1037/0022-3514.84.4.813 Occurrence Handle12703650
PJ Allison C Guichard L Gilain (2000) ArticleTitleA prospective investigation of dispositional optimism as a predictor of health-related quality of life in head and neck cancer patients Qual Life Res 9 951–960 Occurrence Handle10.1023/A:1008931906253 Occurrence Handle11284214
GA Brenes SR Rapp WJ Rejeski ME Miller (2002) ArticleTitleDo optimism and pessimism predict physical functioning? J Behav Med 25 IssueID3 219–231 Occurrence Handle10.1023/A:1015376510466 Occurrence Handle12055774
T Maruta RC Colligan M Malinchoc KP Offord (2002) ArticleTitleOptimism–pessimism assessed in the 1960s and self-reported health status 30 years later Mayo Clin Proc 77 IssueID8 748–753 Occurrence Handle12173709
H Achat I Kawachi A Spiro D DeMolles D Sparrow (2000) ArticleTitleOptimism and depression as predictors of physical and mental health functioning: The normative aging study Ann Behav Med 22 IssueID2 127–130 Occurrence Handle10962705
LB Wenzel DL Fairclough MJ Brady et al. (1999) ArticleTitleAge-related differences in the quality of life of breast carcinoma patients after treatment Cancer 86 1768–1774 Occurrence Handle10.1002/(SICI)1097-0142(19991101)86:9<1768::AID-CNCR19>3.0.CO;2-O Occurrence Handle10547550
M Carlsson E Hamrin R. Lindqvist (1999) ArticleTitlePsychometric assessment of life satisfaction questionnair (LSQ) and comparison of a randomised sample of Swedish women and those suffering from breast cancer Qual Life Res 8 245–253 Occurrence Handle10.1023/A:1008875306645 Occurrence Handle10472155
MT King P Kenny A Shiell et al. (2000) ArticleTitleQuality of life three months and one year after first treatment for early stage breast cancer: Influence of treatment and patients characteristics Qual Life Res 9 789–800 Occurrence Handle10.1023/A:1008936830764 Occurrence Handle11297021
JH Rowland KA Desmond BE Meyerowitz et al. (2000) ArticleTitleRole of breast reconstructive surgery in physical and emotional outcomes among breast cancer survivors J Natl Cancer Inst 92 1422–1429 Occurrence Handle10.1093/jnci/92.17.1422 Occurrence Handle10974078
M Amichette O Caffo (2001) ArticleTitleQuality of life in patients with early stage breast carcinoma treated with conservation surgery and radiotherapy A Italian monoinstitutional study. Tumori 87 78–84
B Cimprich DL Ronis G Martinez-Ramos (2002) ArticleTitleAge at diagnosis and quality of life in breast cancer survivors Cancer Pract 10 85–93 Occurrence Handle10.1046/j.1523-5394.2002.102006.x Occurrence Handle11903273
PA Ganz KA Desmond B Leedham et al. (2002) ArticleTitleQuality of life in long-term disease-free survivors of breast cancer: A follow-up study J Natl Cancer Inst 94 39–49 Occurrence Handle11773281
JS Mandelblatt SB Edge NJ Merol et al. (2003) ArticleTitlePredictors of long-term outcomes on older breast cancer survivors: Perceptions versus patterns care J Clin Oncol 21 855–863 Occurrence Handle10.1200/JCO.2003.05.007 Occurrence Handle12610185
MA Stewart (1995) ArticleTitleEffective physician–patient communication and health outcomes: A review CMAJ 152 1423–1433 Occurrence Handle7728691
D Curran Dongen JP van NK Aaronson et al. (1998) ArticleTitleQuality of Life of early-stage breast cancer patients treated with radical mastectomy or breast-conserving procedures: Results of EORTC trial 10801.The European organization for Research and Treatment of Cancer (EORTC), Breast Cancer Co-operative Group (BCCG) Eur J Cancer 34 307–314 Occurrence Handle10.1016/S0959-8049(97)00312-2 Occurrence Handle9640214
P Kenny MT King A Shiell et al. (2000) ArticleTitleEarly stage breast cancer: Cost and quality of life one year after treatment by mastectomy or conservative surgery and radiation therapy Breast 9 37–44 Occurrence Handle10.1054/brst.1999.0111 Occurrence Handle14731583
K Hartl W Janni R Kastner et al. (2003) ArticleTitleImpact of medical and demographic factors on long-term quality of life and body image of breast cancer patients Ann Oncol 14 1064–1071 Occurrence Handle10.1093/annonc/mdg289 Occurrence Handle12853348
K Shimozuma PA Ganz J Petersen K Hirji (1999) ArticleTitleQuality of life in the first years after breast cancer surgery: Rehabilitation needs and patterns of recovery Breast Cancer Res Treat 56 45–57 Occurrence Handle10.1023/A:1006214830854 Occurrence Handle10517342
W Janni D Rjosk T Dimpfl et al. (2001) ArticleTitleQuality of life influenced by primary surgical treatment for stage I–III breast cancer–long term follow-up of a matched-pair analysis Ann Surg Oncol 8 542–548 Occurrence Handle11456055
MR Andersen N Urban (1999) ArticleTitleInvolvement in decision-making and breast cancer survivors quality of life Ann Behav Med 21 IssueID3 201–209 Occurrence Handle10626025
JM Deadman SJ Leinster RG Owens ME Dewey PD Slade (2001) ArticleTitleTaking responsibility for cancer treatment Soc Sci Med 53 669–677 Occurrence Handle10.1016/S0277-9536(00)00369-5 Occurrence Handle11478545
S Petersen RC Schwartz E Sherman-Slate H Frost JL Straub N Damjanov (2003) ArticleTitleRelationship of depression and anxiety to cancer patients’ medical decision-making Psychol Rep 93 323–334 Occurrence Handle14650650
RL Jr Street B Voigt (1997) ArticleTitlePatient participation in deciding breast cancer treatment and subsequent quality of life Med Decis Making 17 IssueID3 298–306 Occurrence Handle9219190
A Moyer P Salovey (1998) ArticleTitlePatient participation in treatment decision making and the psychological consequences of breast cancer surgery Women Health 4 103–116
PL Tomich VS Helgeson (2002) ArticleTitleFive years later: A cross-sectional comparison of breast cancer survivors with health women Psycho Oncol 11 154–169 Occurrence Handle10.1002/pon.570
M Dorval E Maunsell L Deschenes et al. (1998) ArticleTitleLong-term quality of life after breast cancer: Comparison of 8-year survivors with population controls J Clin Oncol 16 487–494 Occurrence Handle9469332
PA Ganz JH Rowland K Desmond et al. (1998) ArticleTitleLife after breast cancer: Understanding women’s health-related quality of life and sexual functioning J Clin Oncol 16 501–514 Occurrence Handle9469334
MA Andrykowski SL Curran R Lightner (1998) ArticleTitleOff-treatment fatigue in breast cancer survivors: A controlled comparison J Behav Med 21 1–18 Occurrence Handle10.1023/A:1018700303959 Occurrence Handle9547419
P Stone M Richards R A’Hern et al. (2000) ArticleTitleA study to investigate the prevalence, severity and correlates of fatigue among patients with cancer in comparison with a control group of volunteers’ cancer Ann Oncol 11 561–567 Occurrence Handle10.1023/A:1008331230608 Occurrence Handle10907949
TN Chirikos A Russell-Jacobs PB Jacobsen (2002) ArticleTitleFunctional impairment and the economic consequences of female breast cancer Women Health 36 IssueID1 1–20 Occurrence Handle10.1300/J013v36n01_01
MJ Hjermstad PM Fayers K Bjordal et al. (1998) ArticleTitleHealth-related quality of life in the General Norwegian population assessed by the European organization for Research and Treatment of Cancer Core Quality-of-Life Questionnaire: The QLQ-C3=(+3) J Clin Oncol 16 1188–1196 Occurrence Handle9508207
I Schou Ø Ekeberg CM Ruland et al. (2002) ArticleTitleDo women newly diagnosed with breast cancer and consulting surgeon assess decision-making equally? Breast 11 434–441 Occurrence Handle10.1054/brst.2002.0454 Occurrence Handle14965708
NK Aaronson S Ahmedzai B Bergman et al. (1993) ArticleTitleThe European organization for Research and Treatment of cancer QLQ-C30: A Quality-of-life instrument for use in international clinical trials in oncology J Natl Cancer Inst 85 365–376 Occurrence Handle8433390
Fayers P, Aaronson N, Bjordal K, et al. EORTC QLQ-C30 Scoring Manual. 3 ed. Brussels: Edition January, 2001
U Versonesi S Kleist Particlevon K Redmond et al. (1999) ArticleTitleCaring about women and cancer (CAWAC): A European survey of the perspectives and experiences of women with female cancers Eur J Cancer 35 IssueID12 1667–1675 Occurrence Handle10.1016/S0959-8049(99)00170-7 Occurrence Handle10674011
R Kåresen F Langmark (2000) ArticleTitlePsychological and economic status of Norwegian women operated for breast or gynaecologic cancer Tidsskr nor Lægeforen 120 2708–2741
MF Scheier CS Carver MW Bridges (1994) ArticleTitleDistinguishing optimism from neuroticism (and trait anxiety, self-mastery and self-esteem): A re-evaluation of the life orientation test J Per Soc Psychol 67 1063–1078 Occurrence Handle10.1037//0022-3514.67.6.1063
MJ Hjermstad PM Fayers K Bjordal et al. (1998) ArticleTitleUsing reference data on quality of life–the importance of adjusting for age and gender, exemplified by the EORTC QLQ-C30 (+3) Eur J Cancer 34 1381–1389 Occurrence Handle10.1016/S0959-8049(98)00136-1 Occurrence Handle9849421
J Cohen (1988) Statistical Power Analysis for the Behavioural Sciences, 2 ed. Lawrence Erlbaum Associates Hillsdale, NJ
NJ Warner M King AO Langlands et al. (1999) ArticleTitleSymptoms 2 weeks, 3 months and 12 months after treatment of early breast cancer: The patients’ perspectives Breast 8 273–277 Occurrence Handle10.1054/brst.1999.0069 Occurrence Handle14965744
J Kerr J Engel A Schesingerr-Raab et al. (2003) ArticleTitleCommunication, quality of life and age: Results of a 5-year prospective study in breast cancer patients Ann Oncol 14 IssueID3 421–427 Occurrence Handle10.1093/annonc/mdg098 Occurrence Handle12598348
JJ Olin (2001) ArticleTitleCognitive function after systematic therapy for breast cancer Oncology 15 613–618 Occurrence Handle11396356
FS Dam Particlevan SB Schagen MJ Muller et al. (1998) ArticleTitleImpairement of cognitive function in women receiving adjuvant treatment for high-risk breast cancer: High-dose versus standard-dose chemotherapy J Natl Cancer Inst 90 210–218 Occurrence Handle10.1093/jnci/90.3.210 Occurrence Handle9462678
E Warner al-N Keshavjee R Shupak A Bellini (1997) ArticleTitleRheumatic symptoms following adjuvant therapy for breast cancer Am J Clin Oncol 29 IssueID3 322–326 Occurrence Handle10.1097/00000421-199706000-00025
MT King (1996) ArticleTitleThe interpretation of scores from the EORTC quality of life questionnaire QlQ-C30 Qual Life Res 5 555–567 Occurrence Handle10.1007/BF00439229 Occurrence Handle8993101
D Cella (2000) ArticleTitleDiscussion of issues concerning the quality of life in cancer patients Int J Pharm Med 14 95–97 Occurrence Handle10.1097/00124363-200004000-00007
J Engel J Kerr Schlesinger-Raab et al. (2003) ArticleTitlePredictors of quality of life of breast cancer patients Acta Oncol 42 710–718 Occurrence Handle10.1080/02841860310017658 Occurrence Handle14690156
SK Al-Ghazal L Fallowfield RW Blamey (2000) ArticleTitleComparison of psychological aspects and patients satisfaction following breast cancer surgery, simple mastectomy and breast reconstruction Eur J Cancer 36 1938–1943 Occurrence Handle10.1016/S0959-8049(00)00197-0 Occurrence Handle11000574
J Engel J Kerr Schlesinger-Raab et al. (2004) ArticleTitleQuality of life following breast-conserving therapy or mastectomy: results of a 5-year prospective study Breast J 10 223–231 Occurrence Handle10.1111/j.1075-122X.2004.21323.x Occurrence Handle15125749
PA Ganz KA Desmond TR Belin et al. (1999) ArticleTitlePredictors of sexual health in women after a breast cancer diagnosis J Clin Oncol 17 2371–2380 Occurrence Handle10561299
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Schou, I., Ekeberg, Ø., Sandvik, L. et al. Multiple Predictors of Health-Related Quality of Life in Early Stage Breast Cancer. Data from a Year Follow-up Study Compared with the General Population. Qual Life Res 14, 1813–1823 (2005). https://doi.org/10.1007/s11136-005-4344-z
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DOI: https://doi.org/10.1007/s11136-005-4344-z