Abstract
Quality of life of patients treated for stage IV breast cancer. Multidimensional assessment and examination of determining factors
- Medical Oncology Department, Hospital Universitario de Navarra, Pamplona, Spain
- Radiotherapeutic Oncology Department, Hospital Universitario de Navarra, Pamplona, Spain
- Institute for Health Research of Navarre (IdiSNA), Pamplona, Spain
- Methodology Unit, Navarrabiomed, RICAPPS, Spain
- Bottomley Consulting Group, Brussels, Belgium
Introduction:
Metastatic breast cancer (MBC) can profoundly impact patients’ lives. The health-related quality of life (HRQOL) of MBC metavivors remains a paramount concern. This study examined the multifaceted aspects of HRQOL in MBC metavivors.
Material and methods:
Ninety-eight participants with over 4 years of metastatic disease were evaluated using the European Organisation for Research and Treatment of Cancer (EORTC) questionnaires QLQ-C30, QLQ-BR42 and QLQ-BM22 alongside the Assessment of Survivor Concerns (ASC) questionnaire.
Results:
HRQOL scores were high (> 80/ 100 points) in some HRQOL areas, including role, cognitive and social functioning and breast symptoms. Moderate limitations (> 30 points) occurred in global QOL and financial impact (QLQ-C30); sexual functioning, sexual enjoyment, future perspective, breast satisfaction, upset by hair loss, skeletal symptoms, and weight gain (QLQ-BR42); and psychosocial aspects of QLQ-BM22. Worries were moderate in the two ASC factors (6.8 and 5.3) and the global scale (11.7). The multivariate model that best explains high risk of low global QOL included limiting comorbidity, financial impact, cancer worry and role functioning (R2 = 0.692). Patients with only bone metastases showed higher cancer and health worries (ASC scale) than patients with soft tissues and visceral sites.
Conclusions:
This study shows that MBC metavivors adapted well to their situation and underscores the persistent HRQOL challenges they face. In-depth analysis of the QLQ-C30 global score highlights the need to address not only medical aspects but also integrated psychosocial and economical support in MBC metavivor care. HRQOL variations across metastatic sites underscore the need to tailor interventions to address site-specific challenges.
Keywords
neoplasm metastasis, breast neoplasms, metavivors, quality of life
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