Background
Methods
Results
Statistics
Year | Breast cancer | Quality of life | BC+QOL* | Papers reviewed** |
---|---|---|---|---|
1974 | 246 | 13 | 1 | 1 |
1975 | 312 | 23 | 0 | 0 |
1976 | 358 | 34 | 1 | 1 |
1977 | 522 | 27 | 0 | 0 |
1978 | 527 | 33 | 0 | 0 |
1979 | 489 | 34 | 0 | 0 |
1980 | 662 | 36 | 1 | 1 |
1981 | 634 | 45 | 1 | 0 |
1982 | 647 | 71 | 1 | 1 |
1983 | 661 | 89 | 2 | 2 |
1984 | 830 | 73 | 0 | 0 |
1985 | 844 | 97 | 2 | 2 |
1986 | 920 | 134 | 1 | 1 |
1987 | 961 | 211 | 2 | 2 |
1988 | 1125 | 223 | 2 | 2 |
1989 | 1333 | 294 | 2 | 2 |
1990 | 1470 | 422 | 7 | 6 |
1991 | 1423 | 394 | 8 | 7 |
1992 | 1805 | 603 | 8 | 8 |
1993 | 2088 | 641 | 18 | 17 |
1994 | 2342 | 747 | 16 | 15 |
1995 | 2444 | 948 | 11 | 10 |
1996 | 2926 | 1422 | 16 | 15 |
1997 | 3249 | 1756 | 19 | 16 |
1998 | 3597 | 2049 | 29 | 25 |
1999 | 3872 | 2457 | 39 | 30 |
2000 | 5026 | 2639 | 37 | 30 |
2001 | 5206 | 2985 | 34 | 27 |
2002 | 5720 | 3233 | 42 | 26 |
2003 | 6441 | 3900 | 38 | 31 |
2004 | 7422 | 4811 | 74 | 47 |
2005 | 7862 | 5276 | 73 | 53 |
2006 | 7021 | 4592 | 63 | 48 |
2007 | 4641 | 2207 | 58 | 51 |
Total
| 85626 | 42519 | 606 | 477 |
Reviews
Author(s) [Ref.] | Year | Main focus | Conclusion(s) |
---|---|---|---|
McEvoy and McCorkle [7] | 1990 | QOL in advanced breast cancer | Efforts to manage advanced breast cancer must include both current medical therapies and attention to the critical factors associated with enhancing their QOL. |
Kiebert et al. [8] | 1991 | Impact of breast conserving surgery vs. mastectomy on QOL | There were no substantial differences between the two treatment modalities except for body image and sexual functioning in favor of breast conserving surgery. |
Aarenson [9] | 1993 | Assessments of QOL and benefits from adjuvant therapies | Adjuvant therapies could improve QOL in breast cancer patients. |
Bryson and Plosker [10] | 1993 | Tamoxifen as adjuvant therapy | Tamoxifen has a low cost-utility ratio in postmenopausal women with node-positive, estrogen receptor-positive breast cancer. |
Stefanek [11] | 1994 | QOL research, provider-patient communication, and psychological distress of spouses and other relatives of breast cancer patients | This review summarizes and critiques publications in three identified areas. |
Ganz [12] | 1994 | Review of various approaches to the measurement of QOL, the important QOL issues in the treatment of breast cancer, and what is known about QOL of older women with breast cancer | Ongoing and future research using newer approaches to QOL assessment should provide additional information on this important topic. |
Osoba [13] | 1994 | QOL as a treatment endpoint | Advances in understanding HRQOL in metastatic breast cancer will aid the development of rational treatment policies. |
Carlson [14] | 1998 | QOL in metastatic breast cancer | Clinician must balance anti-tumor activity, performance status, and the usual toxicity measures as surrogates for QOL associated with each specific therapy. |
Leedham and Ganz [15] | 1999 | Psychological concerns and mental health | Psychological concerns and mental health are important issues for breast cancer patients and should be recognized and treated when necessary. |
Rustoen and Begnum [16] | 2000 | Nursing practice | Nurses play an important role in meeting the needs of breast cancer patients. |
Shapiro et al. [17] | 2001 | Relationship between psychosocial variables and QOL | A broader, more integrative framework that includes psychosocial factors is needed to evaluate breast cancer consequences. |
Partridge et al. [18] | 2001 | QOL before, during and after high-dose chemotherapy | Resulting transient impaired overall QOL with subsequent improvement over time. |
Kurtz and Dufour [19] | 2002 | QOL in older patients with metastatic disease receiving either standard treatment or new drugs | Aromatase inhibitors (such as taxanes and orally administered chemotherapy) provide similar or a better QOL as compared to first line endocrine therapy with tamoxifen. |
Costantino [20] | 2002 | Hormonal treatments in metastatic breast cancer patients | QOL data is useful for both clinicians and patients in evaluating treatment options and developing treatment strategies. |
Fallowfield [21] | 2004 | Hormonal therapies | Tolerability profiles of available treatment options are highlighted. |
Sammarco [22] | 2004 | QOL of older breast cancer patients | Outpatient and long-term care should become a key setting for implementation of QOL interventions for women with breast cancer. |
Knobf [23] | 2006 | Endocrine effects of adjuvant therapy in younger survivors | Causes premature menopause that is associated with poorer QOL, decreased sexual functioning, menopausal symptom distress, psychosocial distress related to infertility, and infertility. |
Kayl and Meyers [24] | 2006 | Side effects of chemotherapy | QOL issues may help to guide patient-care decision. |
Diel [25] | 2007 | Effectiveness of bisphosphonates on bone pain and quality of life in breast cancer patients with metastatic bone disease | Clinical trial data demonstrate that bisphosphonates offer significant and sustained relief from bone pain and can also improve quality of life in patients with metastatic breast cancer. New treatment schedules using high dose bisphosphonates can offer rapid relief of acute, and severe bone pain. |
Rozenberg et al. [26] | 2007 | Co-morbid conditions and breast cancer | Women with breast cancer and three or more co-morbid conditions have a 20-fold higher rate of mortality from causes other than breast cancer and a 4-fold higher rate of all-cause mortality when compared with patients who have none. |
Author(s) [Ref.] | Year | Main focus | Conclusion(s) |
---|---|---|---|
Irwig and Bennetts [27] | 1997 | A systematic review of quality of life after breast conservation or mastectomy | Apart body image it is unclear whether breast conservation or mastectomy results in better psychosocial outcomes. |
Bottomley and Therasse [28] | 2002 | Systemic therapy (chemotherapy, hormonal therapy, or biological therapy) in advanced breast cancer (1995–2001) | QOL data provide invaluable insights into the treatment and care of patients. |
Shimozuma et al. [29] | 2002 | Systematic overview of the literature (1982–1999) | To date there have been almost no appropriate systematic overviews or guidelines issued for QOL assessment studies related to breast cancer. |
Goodwin et al. [30] | 2003 | Randomized clinical trials of treatment (review of literature from 1980–2001) | Until results of ongoing trials in breast cancer are available, caution is recommended in initiating new QOL studies unless treatment equivalency is expected or unless unique or specific issues can be addressed. |
Rietman et al. [31] | 2003 | Late morbidity of breast cancer (review of literature from 1980 to 2000) | Significant relationship between late morbidity and restrictions of daily activities and poorer QOL was reported. |
Payne et al. [32] | 2003 | Racial disparities in the palliative care for African-American (review of literature from 1985 to 2000) | Differences in treatment patterns, pain management, and hospice care exist between African-American and other ethnic groups. |
Fossati [33] | 2004 | Randomized clinical trials of cytotoxic or hormonal treatments in advanced breast cancer (review of published literature before Dec 2003 | QOL assessments added relatively little value to classical clinical endpoints. |
Mols et al. [34] | 2005 | Systematic review among long-term survivors | Focusing on the long-term effects of breast cancer is important when evaluating the full extent of cancer treatment. |
Grimison and Stockler [35] | 2007 | Adjuvant systemic therapy for early-stage breast cancer (review of literature from 1996 to Feb. 2007) | For the majority of breast cancer patients most aspects of health-related quality of life recover after adjuvant chemotherapy ends without long-term effects except vasomotor symptoms and sexual dysfunction. |
Two historical papers
Instruments used
Types of measures | Measures full name | Abbreviation |
---|---|---|
General measures
| ||
Short Form Health Survey | SF-36 | |
Spitzer Quality of Life Index | QLI | |
Sickness Impact Profile | SIP | |
Ferrans and Powers Quality of Life Index | QLI | |
Cancer specific measures
| ||
European Organization for Research and Treatment of Cancer Core quality of Life questionnaire | EORTC QLQ-C30 | |
Functional Assessment of Chronic Illness Therapy General Questionnaire | FACIT-G (formerly FACT) | |
Functional Living Index-Cancer | FLI-C | |
Ferrans and Powers Quality of Life Index-Cancer | QLI-C | |
Breast cancer specific measures
| ||
European Organization for Research and Treatment of Cancer Breast Cancer Quality of Life Questionnaire | EORTC QLQ-BR23 | |
Functional Assessment of Chronic Illness Therapy-Breast | FCIT-B | |
Breast Cancer Chemotherapy Questionnaire | BCQ | |
The Satisfaction with Life Domains Scale for Breast Cancer | SLDS-BC | |
Psychological measures
| ||
General Health Questionnaire-28 | GHQ-28 | |
Hospital Anxiety and Depression Scale | HADS | |
Beck Depression Inventory | BDI | |
Center for Epidemiologic Studies Depression Scale | CES-D | |
State-Trait Anxiety Inventory | STAI | |
Profile Mood State | PMS | |
Mental Adjustment to Cancer Scale | MACS | |
Psychosocial Adjustment to Illness Scale | PAIS | |
Symptom measures
| ||
Functional Assessment of Chronic Illness Therapy-Fatigue | FACIT-F | |
Piper Fatigue Scale | PFS | |
Multidimensional Fatigue Inventory | MFI | |
Functional Assessment of Chronic Illness Therapy-B plus Arm Morbidity Subscale | FACIT-B + 4 | |
Hot Flash Related Interference Scale | HFRDIS | |
Shoulder Disability Questionnaire | SDQ | |
Brief Pain Inventory | BPI | |
McGill Pain Questionnaire | MPQ | |
Memorial Symptom Assessment Scale | MSAS | |
Rotterdam Symptom Checklist | RSC | |
Other measures
| ||
Functional Assessment of Chronic Illness Therapy-Spiritual | FACIT-SP | |
Body Image Scale | BIS | |
Body Image After Breast Cancer Questionnaire | BIBCQ | |
Watts Sexual Functioning Questionnaire | WSFQ | |
Social Support Questionnaire | SSQ | |
Life Satisfaction Questionnaire | LSQ | |
Satisfaction With Life Scale | SWLS |
Validation studies
Author(s) [Ref.] | Year | Instrument | Main focus |
---|---|---|---|
Levine et al. [38] | 1988 | The Breast Cancer Chemotherapy Questionnaire (BCQ) | Development an outcome measure in clinical trials of adjuvant chemotherapy |
Ciampi et al. [39] | 1988 | A 27 item Linear Analog Self Assessment | Factor analysis indicating disease and treatment-related, physical, emotional and social health summary scores |
Tamburini et al. [40] | 1991 | Two simple index | To assess the impact of therapy on QOL in patients receiving chemotherapy for operable breast cancer |
Osoba et al. [41] | 1994 | The European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire (EORTC QLQ-C30) | Evaluation of psychometric properties and responsiveness |
Carlsson and Hamrin [42] | 1996 | The Life Satisfaction Questionnaire (LSQ-32) | Development a tool to measure life satisfaction in breast cancer patients |
Sprangers et al. [43] | 1996 | The European Organization for Research and Treatment of Cancer Breast Cancer Specific Quality of Life Questionnaire (EORTC QLQ-BR23) | Development of a breast cancer specific QOL measure |
Brady et al. [44] | 1997 | The Functional Assessment of Cancer Therapy Breast Cancer Specific Questionnaire (FACT-B) | Development of a breast cancer specific QOL measure |
de Haes and Olschewski [45] | 1998 | The Rotterdam Symptom Checklist (RSC) | Cross cultural validation |
McLachlan et al. [46] | 1998 | The EORTC QLQ-C30 | Validation as a measure of psychological function |
Fallowfiled et al [47] | 1999 | An endocrine symptom subscale for the FACT-B (FACT-B plus ES) | Validation in women undergoing hormonal therapy for breast cancer |
Montazeri et al. [48] | 2000 | The EORTC QLQ-BR23 | Validation of the Iranian version |
Mihailova et al. [49] | 2001 | The EORTC QLQ-C30 and the QLQ-BR23 | Validation of the Bulgarian version |
Coster et al. [50] | 2001 | The Impact of Arm Morbidity (FACT-B+4) | Development a QOL scale to assess the impact of arm morbidity post-operatively |
Carpenter [51] | 2001 | The Hot Flash Related Daily Interference Scale | Development of a tool for measuring the impact of hot flashes on QOL |
Pandey et al. [52] | 2002 | The FACT Breast Cancer Specific Questionnaire (FACT-B) | Validation of the Malayalam version |
Chie et al. [53] | 2003 | The EORTC QLQ-C30 and the EORTC QLQ-BR23 | Validation of the Taiwan Chinese version |
Lee et al. [54] | 2004 | The Functional Assessment of Cancer Therapy-General (FACT-G) | Validation of the Korean version |
Yun et al. [55] | 2004 | The EORTC QLQ-BR23 | Cross-cultural application in Korea |
Parmar et al. [56] | 2005 | The EORTC QLQ-C30 | Validation of the Indian version |
Avis and Foley [57] | 2006 | The Quality of life in Adult Cancer Survivors (QLACS) | Evaluation in long term breast cancer survivors |
Wan et al. [58] | 2007 | The FACT-B | Validation of the simplified Chinese version |
Wan et al. [59] | 2007 | The EORTC QLQ-BR53 | Psychometric properties of the simplified Chinese version |
Measurement issues
Author(s) [Ref.] | Year | Main focus | Conclusion(s)/Recommendation |
---|---|---|---|
Baum et al. [60] | 1990 | The issue of measuring QOL in advanced breast cancer | Efforts are being made to find out ways to measure QOL in advanced breast cancer patients. |
Sutherland et al. [61] | 1990 | Ratings of the importance of QOL variables | Breast cancer patients give different weights to different QOL variables. |
Gelber et al. [62] | 1992 | Explaining about the QOL adjusted Time Without Symptom and Toxicity | Integration of two methods (QOL and symptom free duration) could provide a new tool. |
Ganz et al. [63] | 1992 | The influence of multiple variables on the relationship of age to QOL | The casement plot methodology should be employed for simultaneous evaluation of multiple variables. |
Gelber et al. [64] | 1993 | Description of survival estimates with applications to QOL evaluation (Quality adjusted Time Without Symptoms of disease and Toxicity of treatment) | Estimation showed that patients continued to benefit greatly from long-term-duration chemotherapy between 5 and 10 years following treatment. |
Hyden et al. [65] | 1993 | Pitfalls in collecting QOL data | Several recommendations were made: (a) build support for QOL assessment among the group's leadership, (b) involve physicians and oncology nurses in the study design, (c) identify a QOL liaison at each participating institution, and (d) aggressively monitor the quality and timeliness of data submission. |
Fallowfield [66] | 1993 | Measurement issues | Some recommendations for selecting well validated measures. |
Gerard et al. [67] | 1993 | Framing and labeling effects in measuring quality adjusted life years | A significant difference was found in the particular values of descriptions that were written in the third person that differed in terms of whether the word "cancer" was used. |
Hurny et al. [68] | 1994 | Timing of baseline QOL assessment | Timing is an important consideration in QOL assessment. |
Fallowfield [69] | 1995 | Discussion on some instruments used to measure QOL | Monitoring QOL in breast cancer should be a mandatory part of follow-up in clinical trials. |
Hietanen [70] | 1996 | Measurement and practical aspects of QOL assessment | Main factors affecting QOL in the treatment of breast cancer. |
Bernhard et al. [71] | 1997 | The International Breast Cancer Study Group (IBCSG) approach | Confirmation of the feasibility, validity and clinical relevance of quality of life assessment. |
Bernhard et al. [72] | 1998 | Factors affecting baseline QOL assessment | Cultural and biomedical factors are influencing baseline QOL data and should be considered when evaluating the impact of treatment. |
Bernhard et al. [73] | 1998 | Practical issues and factors associated with missing data | The factors most highly associated with missing data were institution and chemotherapy compliance. |
Ganz et al. [74] | 1998 | Compliance with QOL data collection | Educational level of a trial participants might contribute to it compliance. |
Coates and Gebski [75] | 1998 | Approaches to missing data | Missing data cannot be assumed to be similar to those available. Optimal assessment requires careful prospective attention to complete data collection. |
Jansen et al. [76] | 2000 | Response shift | Significant recalibration effects were observed. |
Curran et al. [77] | 2000 | Summary measures and statistics | Different techniques in analysis might result in different conclusions. |
Perez et al. [78] | 2001 | The application of a time trade-off utility measure | The utility measure and a QOL measure showed fair to moderate concordance. |
Nagel et al. [79] | 2001 | A cluster analytic approach to analyze quality of life data | QOL scores could identify clinically meaningful subgroups of patients. |
Mosconi et al. [80] | 2001 | A general introduction to the debate on the methodological issues involved in QOL evaluation | Open questions regarding the use of QOL measures in surgical, adjuvant therapy and metastatic studies. |
Efficace et al. [81] | 2002 | Evaluating reliability, validity and cultural relevance of QOL measures in clinical trials | Suggestions for selecting future measures for use in breast cancer population of patients. |
Wilson et al. [82] | 2005 | Comparing two QOL measures (the Rand 36-item and the Functional Living Index-Cancer) | Neither questionnaire can be replaced by each other in studies of QOL in breast cancer patients. |
Carver et al. [83] | 2006 | Assessment of demographic, medical and psychological variables on outcome | Different aspects of QOL at long-term follow-up had different antecedents. |
Perry et al. [84] | 2007 | Benefits, acceptability and utilization of QOL assessment in women with breast cancer | Summarized the benefits, challenges, and barriers of QOL measurement for female breast cancer patients. |
Surgical treatment
Author (s) [Ref.] | Year | Treatment (assessment time) | Conclusion(s) |
---|---|---|---|
de Haes et al. [85] | 1985 | MAS vs. tumorectomy (11 months after surgery) | No differences expect worse body image in MAS patients. |
de Haes et al. [86] | 1986 | MAS vs. tumorectomy (11 and 18 months after surgery) | Overall QOL improved over time in both groups; poor body image in MAS. |
Ganz et al. [87] | 1992 | MAS vs. BCS after one year | No significant differences in QOL and both groups improved; BCS patients did not experience significantly better QOL but had fewer problems with clothing and body image. |
Shimozuma et al. [88] | 1994 | Surgery-any | Hospitalization had a strong negative relation to overall QOL; type of surgery had no significant association with QOL. |
Neises et al. [89] | 1994 | MAS or BCS | Older women suffer as much as younger patients after MAS. |
Fallowfield [90] | 1994 | Surgery and tamoxifen vs. tamoxifen alone | At 2 years similar psychological health; no evidence of impaired QOL for elderly women after surgery |
Shimozuma et al. [91] | 1995 | MRM or BCS (before surgery and 3 times up 2 years after) | No significant differences in overall QOL; patients with BCS need more psychological support. |
Hart et al. [92] | 1997 | MAS + prostheses or MAS + reconstruction or MAS alone | No one technique is necessary for all women to optimize QOL; women should choose and make their own decisions. |
Dorval et al. [93] | 1998 | Partial or total MAS (3 and 18 months after) | Both appeared to be equivalent in long-term QOL. Younger women might benefit more from partial MAS. |
Curran et al. [94] | 1998 | MRM vs. BCS | Significant benefit in body image and satisfaction in BCS group; no difference in fear of recurrence. |
Wapnir et al. [95] | 1999 | Lumpectomy with axillary dissection (LAD) or mastectomy | No major differences except for dressing, comfort with nudity and sexual drive in favor of ALD. |
Shimozuma et al. [96] | 1999 | MRM or BCS (1 year after) | At one year good QOL, with no relationship to the type of surgery. |
Pusic et al. [97] | 1999 | Lumpectomy + irradiation or MAS + reconstruction or MAS alone | Postoperative QOL varied with age; for age less than 55 QOL was lowest for MAS, over 55 was lowest for lumpectomy. |
Amichetti et al. [98] | 1999 | BCS + irradiation in non-infiltrating breast cancer | Good QOL and body image and lack of negative impact on sexuality. |
King et al. [99] | 2000 | MAS or BCS (3 months and 1 year after) | Most symptoms declined over time but arm and menopausal symptoms persisted; worse QOL in younger patients. |
Kenny et al. [100] | 2000 | MAS or BCS + irradiation (1 year after) | Better body image and physical function in BCS; more impact on younger women regardless of treatment type. |
Nissen et al. [101] | 2001 | MAS or MAS + reconstruction or BCS (6 times assessment up to 2 years after) | QOL other than body image were not better in BCS or MAS + reconstruction than in who had MAS alone; MAS + reconstruction was associated with greater mood disturbance and poorer QOL. |
Janni et al. [102] | 2001 | MAS or BCS (median 46 months follow-up) | Surgical modalities had no long-term impact on overall QOL, but certain body image related problems in MAS was observed. |
Girotto et al. [103] | 2003 | MAS + reconstruction in older women | Improved QOL in older patients especially improved mental health. |
Cocquyt et al. [104] | 2003 | Skin-sparing MAS or BCS | Both yielded comparable QOL, but cosmetic outcome was better after skin-sparing MAS. |
Engel et al [105] | 2004 | MAS or BCS (5 years follow-up) | MAS patients had lower body image, role and sexual functioning; BCS should be encouraged in all ages. |
Ganz et al. [106] | 2004 | Lumpectomy + chemotherapy or MAS + chemotherapy or Lumpectomy alone or MAS alone in non-metastatic breast cancer patients | At the end of primary treatment all treatment groups reported good emotional functioning but decreased physical health especially among women who had MAS or received chemotherapy. |
Dubernard et al. [107] | 2004 | SLNB | Axillary procedure affected only QOL related to arm morbidity. |
Elder et al. [108] | 2005 | MAS + immediate breast reconstruction (before and 12 months after) | After 12 months good QOL comparable with aged-matched women from the general population. |
Barranger et al. [109] | 2005 | SLNB vs. ALND in breast-sparing treatment | SLNB was associated with significantly lower mid term morbidity. |
Fleissig [110] | 2006 | SLNB vs. ALND | Regarding arm functioning and QOL the use of SNB was recommended in patients with node negative breast cancer. |
Pandey et al. [111] | 2006 | MAS or BCS | No significant change in overall QOL after surgery; poorer QOL in MAS patients. |
Rietman et al. [112] | 2006 | SLNB or ALND (before and after 2 years) | Less treatment related upper limb morbidity, perceived disability in activities of daily life and worsening of QOL after SNLB compared with ALND. |
Parker et al. [113] | 2007 | MAS or MAS+ reconstruction or BCS (short- and long-term effects on aspects of psychosocial adjustment and QOL | Overall, the general patterns of psychosocial adjustment and QOL were similar among the three surgery groups. |
Systemic therapies
Author(s) [Ref.] | Year | Treatment/patients | Conclusion(s) |
---|---|---|---|
Moore et al. [36] | 1974 | Adrenalectomy + chemotherapy in advanced breast cancer | In most patients the subjective palliation involved a return to normal living. |
Priestman and Baum [37] | 1976 | Chemotherapy in advanced breast cancer | Toxicity is not related to the patients' age and diminished with successive courses of drugs. |
Palmer et al. [114] | 1980 | A single agent vs. five drug combination in node positive primary breast cancer | Better QOL in single agent group. |
Coates et al. [115] | 1987 | Intermittent vs. continuous chemotherapy in metastatic breast cancer | Continuous chemotherapy was better; changes in the QOL were independent prognostic factor of survival. |
Kiebert et al. [116] | 1990 | Peri-operative chemotherapy vs. no chemotherapy in early stage breast cancer | No differences 1 year after; patients considered chemotherapy most burdensome aspect of treatment. |
Gelber et al. [117] | 1991 | Single cycle of combination chemotherapy vs. longer duration chemotherapy for pre-menopausal or chemo-endocrine therapy for postmenopausal women | Better QOL in longer duration chemotherapy or chemo-endocrine therapy. |
Berglund et al. [118] | 1991 | Late effects of adjuvant chemotherapy vs. postoperative radiotherapy in pre- and post-menopausal breast cancer | Chemotherapy patients had higher overall QOL. |
Richards et al. [119] | 1992 | A (weekly for 12 courses vs. every three weeks for 4 courses) in advanced breast cancer | Similar survival but higher psychological distress in the three weeks group. |
Hurny et al. [120] | 1992 | CMF (6 cycles vs. 3 cycles) in operable breast cancer | QOL improved with increasing time from the study entry. |
Campora et al. [121] | 1992 | Adjuvant chemotherapy vs. palliative chemotherapy in metastatic breast cancer | No significant difference between groups. |
Fraser et al. [122] | 1993 | CMF vs. E in advanced breast cancer | Similar survival and no significant difference in overall global QOL. |
Twelves et al. [123] | 1994 | Iododoxorubicin in advanced breast cancer | Little evidence of benefit in terms of physical symptom relief, level of activity, psychological symptoms or global QOL. |
Bertsch and Donaldson. [124] | 1995 | Vinorelbine vs. melphalan | Vinorelbine was better in some aspects of QOL. |
Swain et al. [125] | 1996 | AC + G-CSF in node positive breast cancer | Tolerable physical symptoms and emotional distress. |
McQuellon et al. [126] | 1996 | High-dose chemotherapy + ABMT | No significant difference between pre- and post-treatment QOL. |
Larsen et al. [127] | 1996 | High-dose chemotherapy + ASCT | Resulting in poor physical and emotional health. |
Hurny et al. [128] | 1996 | 6 cycles of CMF vs. 3 cycles CMF in node-positive operable breast cancer | Worse QOL during treatment but not after treatment completion. |
Griffiths and Beaver [129] | 1997 | High-dose chemotherapy in advanced breast cancer | No significant deterioration in QOL. |
Lindley et al. [130] | 1998 | Systemic adjuvant therapy | 2–5 years after treatment good QOL. Small to modest gain was acceptable to women. |
Ganz et al. [131] | 1998 | TAM or chemotherapy alone or chemotherapy + TAM, or no adjuvant therapy | No significant differences in global QOL among treatment groups; those who received chemotherapy had more sexual problems and those who received TAM had more vasomotor symptoms. |
Bernhard et al. [132] | 1999 | Formestane vs. megestrol acetate in postmenopausal advanced breast cancer while on TAM | No significant difference in QOL; baseline QOL was strong predictive for QOL under treatment but not for time to treatment failure. |
Fairclough et al. [133] | 1999 | CAF vs. dose intensive a 16-week multi-drug regimen | Negative impact of the dose intensive 16-week regimen was observed, although Q-TwiST analysis showed a small gain for this regimen. |
Osoba and Burchmore [134] | 1999 | Trastuzumab (Hercptin) in metastatic breast cancer who may or may not have had prior chemotherapy | Trastuzumab was associated with an amelioration of the deleterious effects of chemotherapy alone; the drug was not associated with worsening of QOL. |
McLachlan et al. [135] | 1999 | Chemotherapy in metastatic breast cancer | QOL maintained or improved; patients did not want to trade quantity for QOL. |
Macquart-Moulin et al. [136] | 2000 | High-dose chemotherapy + G-CSF + ASCT in inflammatory breast cancer | QOL deterioration disappeared after treatment and returned to baseline after one year. |
Riccardi et al. [137] | 2000 | Doubling E within FEC vs. FEC in metastatic breast cancer | No significant difference in response or improvement of baseline QOL. |
2000 | Paclitaxel vs. A in advanced breast cancer | QOL appeared to be prognostic for survival and response to treatment. | |
Joly et al. [140] | 2000 | CMF + irradiation vs. irradiation in pre-menopausal breast cancer | Similar QOL was observed. |
Hakamies-Blomqvist et al. [141] | 2000 | T vs. sequential MF in metastatic breast cancer | Difference in QOL was minor favoring MF. |
Broeckel et al. [142] | 2000 | Adjuvant chemotherapy treated breast cancer (after 3 to 36 months) | Younger age, unmarried status, time since diagnosis and chemotherapy completion related to greeter depressive symptoms. |
Carlson et al. [143] | 2001 | High-dose chemotherapy + ASCT in metastatic breast cancer | Anxiety and depression continued to increase, loss of sexual interest, worrying and joint pain were reported. |
Osoba et al. [144] | 2002 | Chemotherapy + Trastuzumab (Hercptin) vs. Chemotherapy alone in metastatic breast cancer | More improved global QOL with chemotherapy + Herceptin. |
Modi et al. [145] | 2002 | Paclitaxel in metastatic breast cancer | QOL benefit in tumor response patients. |
Heidemann et al [146]. | 2002 | Mitoxantrone vs. FEC in metastatic breast cancer | No significant difference in survival or response but a QOL scores favored mitoxantrone. |
Genre et al. [147] | 2002 | High-dose-intensity AC (21 vs. 14 days) | Shortening cycles had a high negative impact on QOL. |
de Haes et al. [148] | 2003 | Goserelin vs. CMF in peri-and pre-menopausal node-positive early breast cancer | Better QOL in favor of goserelin. |
Brandberg et al. [149] | 2003 | Tailored FEC vs. induction FEC followed with high-dose CTCb + peripheral SCT | No significant overall differences were found between groups. |
Land et al. [150] | 2004 | CMF vs. AC in axillary node negative and estrogen receptor negative breast cancer | Overall QOL was equivalent between two groups. |
Fallowfield et al. [151] | 2004 | ANA vs. TAM alone or in combination in postmenopausal early breast cancer | Similar overall QOL impact but some small differences in side effects profiles. |
Bottomely et al. [152] | 2004 | AT vs. AC in metastatic breast cancer | No significant differences in QOL between two groups. |
Bernhard et al. [153] | 2004 | TAM for 5 years or three prior cycles of CMF followed by 57 months TAM in estrogen receptor-negative and estrogen receptor-positive breast cancer | At completion there were no differences by treatment groups. |
Tong et al. [154] | 2005 | Capecitabine, idarubicin and cyclophosphamide (all-oral regimen, XIC) in metastatic breast cancer | No significant decease in global QOL scores. |
Galalae et al. [155] | 2005 | Radiotherapy and adjuvant chemotherapy vs. radiotherapy and hormonal therapy vs. radiotherapy alone after conserving surgery | Adjuvant chemotherapy lowered QOL vs. hormones or radiotherapy alone. |
Elkin et al. [156] | 2005 | Ovarian suppression vs. chemotherapy in pre-menopausal hormone-responsive breast cancer | Assuming equal efficacy ovarian suppression was superior. Efficacy would have impact on treatment choice. |
Conner-Spady et al. [157] | 2005 | High-dose chemotherapy + ABST in breast cancer with poor prognosis | Impaired QOL in short term but improved after 2 years. |
Bottomley et al. [158] | 2005 | Dose-intensives chemotherapy (CE + filgrastim) vs. CEF in locally advanced breast cancer | Groups did not differ in progression free survival; lower QOL in intensified group at short term but no difference at long term. |
Ahles et al. [159] | 2005 | Standard-dose systemic chemotherapy vs. local therapy only in long-term breast cancer survivors | Lower overall QOL in chemotherapy group. |
Peppercorn et al. [160] | 2005 | High-dose chemotherapy + ABMT vs. intermediate-dose chemotherapy in patients with stage II and III breast cancer | Patients who received more intensive therapy experienced transient declines in QOL; by 12 months after, QOL was comparable between the 2 arms, regardless of therapy intensity, and many QOL areas were improved from baseline. |
Semiglazov et al. [161] | 2006 | CMF + mistletoe lectin (PS76A2) vs. CMF + placebo | PS76A2 improved QOL during and after chemotherapy. |
Martin et al. [162] | 2006 | FAC vs. TAC or TAC + G-CSF in node negative breast cancer | Lower QOL in patients treated with TAC. Addition of G-CSF improves QOL. |
Hurria et al. [163] | 2006 | Anthracyclin-based chemotherapy or CMF in older women with breast cancer | QOL maintained in both group. |
Fallowfield et al. [164] | 2006 | EXE vs. TAM after 2–3 years of TAM in postmenopausal primary breast cancer | Temporary decrease in overall QOL for EXE but no other differences. |
Groenvold et al. [165] | 2006 | CMF vs. ovarian ablation | CMF had more negative impact on QOL. |
Cella et al. [166] | 2006 | ANA vs. TAM alone or in combination in postmenopausal breast cancer | ANA and TAM had similar impact on QOL. |
Liu et al. [167] | 2006 | DPPE + A vs. A in patients with advanced or metastatic breast cancer | Patients on A alone had fewer disease and treatment adverse events and better QOL. |
Karamouzis et al. [168] | 2007 | Chemotherapy vs. supportive care in metastatic patients | QOL was better in patients receiving chemotherapy than those under supportive care. |
Hopwood et al. [169] | 2007 | Adjuvant radiotherapy | QOL and mental health were favorable for most patients about to start radiotherapy but younger age and receiving chemotherapy were significant risk factors for poorer QOL. |
Quality of life as predictor of survival
Psychological distress
Author (s) [Ref.] | Years | Main focus | Results/conclusion(s) |
---|---|---|---|
Ferrero et al. [179] | 1994 | Mental adjustment to cancer in newly-diagnosed non-mtastatic breast cancer(an xploratory study) | Strong association between mental adjustment to cancer and reported vague physical symptoms; fighting spirit and denial was associated with better QOL and helpless/hopeless and anxious preoccupation and fatalism were negatively correlated with well-being. |
Ganz et al. [180] | 1996 | Psychosocial concerns 2 and 3 years after primary treatment | Problems associated with physical and recreational activities, body image, and sexual functions were observed, although many positive aspects from cancer experience were reported. |
Maunsell et al. [181] | 1996 | Brief psychological intervention vs. Brief psychological intervention + psychological distress screening | Distress screening did not improve QOL. Minimal psychological intervention at initial treatment alone was recommended. |
Andrykowski et al. [182] | 1996 | Psychological adjustment in women with breast cancer or benign breast problems | Breast cancer patients reported poorer physical health but greater positive psychosocial adaptation and improved life outlook, no difference in psychological distress between two groups. |
Marchioro et al. [183] | 1996 | Evaluation of the impact of a psychological intervention vs. standard care in non-metastatic breast cancer patients | Cognitive psychotherapy and family counseling improved both depression and QOL indexes. |
Weitzner et al. [184] | 1997 | QOL and mood in long-term breast cancer survivors | Psychological measures were found to be more robust predictors of QOL than the demographic variables; long-term survivors continue to experience significant depression and lower QOL. |
Kissane et al. [185] | 1998 | Psychological morbidity in early-stage breast cancer | 45% (135/303) had psychiatric disorder, 42% had depression, anxiety or both; QOL was substantially affected. |
Bloom et al. [186] | 1998 | Intrusiveness of illness in young women with newly-diagnosed breast cancer | Intrusiveness of illness mediated the effect of disease and treatment factors on QOL; neither time post-diagnosis nor type of treatment affected the psychological component of QOL. |
Longman et al. [187] | 1999 | Psychological adjustment over time | Over time depression burden and anxiety burden persist and each was negatively associated with overall and present QOL. |
Cotton et al. [188] | 1999 | Relationship among spiritual well-being, QOL, and psychological adjustment | Spiritual well-being was correlated with both QOL and psychological adjustment, but relationship was found to be more complex and indirect than previously considered. |
Ashing-Giwa [189] | 1999 | Psychological outcome in long-term survivors of breast cancer (focus on African-American) | Patients relied on spiritual faith and family support to cope; socio-cultural contexts of the women's lives need to be considered when studying QOL. |
Lewis et al. [190] | 2001 | Cancer-related intrusive thoughts and social support | In women with social support cancer-related intrusive thoughts had no significant negative impact on QOL, but in women with low social support there was negative effect on QOL. |
Amir and Ramati [191] | 2002 | Post-traumatic distress disorder (PTSD), QOL, and emotional distress in long term survivors of breast cancer and a control group | Higher PSTD, emotional distress and lower QOL in breast cancer mainly due to chemotherapy and disease stage. |
Ganz et al. [192] | 2003 | Psychosocial adjustment 15 months after diagnosis in older women with breast cancer | Psychosocial adjustment at 15 months was predicted by better mental health, emotional social support and better self-rated interaction with health care providers. |
Bordeleau et al. [193] | 2003 | Randomized trial of group psychological support vs. control in metastatic breast cancer | Supportive-expressive group therapy did not appear to influence QOL. |
Badger et al. [194] | 2004 | Depression burden and psychological adjustment | Depression burden had negative effect on psychological adjustment and QOL. |
Schreier and Williams [195] | 2004 | Anxiety in women receiving either radiation or chemotherapy for breast cancer | No significant differences for total QOL or any subscales by treatment; trait anxiety was higher for chemotherapy patients; state anxiety was high and did not decrease over the course of the treatment for either group. |
Kershaw et al. [196] | 2004 | Coping strategies in advanced breast cancer patients and their family caregivers | Patients use more emotional support, religion and positive reframing strategies while family use more alcohol or drug. In both active coping was associated with higher QOL. |
Lehto et al. [197] | 2005 | Psychological stress factors as predictors of QOL in patients receiving surgery alone vs. adjuvant treatment | Psychosocial factors were strongest predictors of QOL but not cancer type or treatment; non-cancer related stresses showed strongest QOL decreasing influence. |
Roth et al. [198] | 2005 | Affective distress in women seeking immediate vs. delayed breast reconstruction after mastectomy | Women seeking immediate breast reconstruction showed relatively higher psychological impairment and physical disability. |
Okamura et al. [199] | 2005 | Psychiatric disorders and associated factors after first breast cancer recurrence | Patients' psychiatric disorders were associated with lower QOL. |
Golden-Kreutz et al. [200] | 2005 | Traumatic stress, perceived global stress, and life events | Initial stress at diagnosis predicted both psychological and physical health at follow-up. |
Deshields et al. [201] | 2005 | Emotional adjustment (at 4 points in time) | Primary psychological changes occur quickly after treatment conclusion and then it appeared to become stabled. |
Laid law et al. [202] | 2005 | Self-hypnosis or Japanese healing or. control | Positive change in anxiety level, a general increase in mood and a better QOL were observed. |
Schou et al. [203] | 2005 | Dispositional optimism and QOL. | Optimism was predictive for better emotional and social functioning one year after surgery; at time of diagnosis and throughout post-diagnosis dispositional optimism was associated with better QOL and fewer symptoms. |
Grabsch et al. [204] | 2006 | Psychological morbidity in advanced breast cancer | 42% (97/277) had a psychiatric disorder, 36% depression or anxiety or both. QOL was substantially affected. |
Antoni et al. [205] | 2006 | Stress management after treatment for breast cancer | Stress management skill taught had beneficial effects on reduced social disruption, and increased emotional well-being, positive states of mind, benefit finding, positive lifestyle change, and positive affect. |
Wonghongkul et al. [206] | 2006 | Uncertainty appraisal coping | Social support was used most to cope and confront-coping used the least; year of survival, uncertainty in illness and harm appraisal influenced QOL. |
Yen et al. [207] | 2006 | Depression and stress in breast cancer versus benign tumor | Stress from health problem was the most significant predictor for QOL among malignant group. |
Costanzo et al. [208] | 2007 | Adjustment to life after treatment | While breast cancer survivors demonstrated good adjustment on general distress following treatment, some women were at risk for sustained distress. |
Wong and Fielding [209] | 2007 | Change in psychological distress and change in QOL | The magnitude of change in psychological distress significantly impacted physical and functional, but not social QOL in breast cancer patients. |
Meneses et al. [210] | 2007 | Psycho-educational intervention and QOL | Breast cancer education intervention is an effective intervention in improving QOL during the first year of breast cancer survivorship. |
Supportive care
Author (s) [Ref.] | Year | Intervention | Results/conclusion(s) |
---|---|---|---|
van Holten-Verzantvoort et al. [217] | 1991 | Pamidronate vs. control to reduce skeletal morbidity | Less short-term mobility impairment and bone pain in treatment group but not at long term. |
Young-McCaughan and Sexton [218] | 1991 | Aerobic exercise | Higher QOL in women who exercised. |
Soukop et al. [219] | 1992 | Ondansetron vs. metoclopramide to control emesis | Ondansetron was significantly superior. |
Kornblith et al. [220] | 1993 | Megestrol acetate in dose-response trial to prevent appetite loss | Lower dose was optimal achieving fewest side effects and a better QOL. |
Clavel et al. [221] | 1993 | Ondansetron to control emesis (review of five randomized trials) | Ondansetron provided significant QOL benefits compared with metoclopramide and alizapride) |
Ashbury et al. [222] | 1998 | One-on-one peer support (Reach to Recovery programme) | Patients were satisfied and the programme had incremental benefits to QOL of patients. |
Lee [223] | 1997 | Social support (Reach to Recovery programme) | Social support plays a vital role in promoting overall QOL. |
Wengstrom et al. [224] | 1999 | Nursing intervention vs. control | No measurable effect on side effects or QOL but proved to have a positive effect in minimizing stress. |
Lachaine et al. [225] | 1999 | Ondansetron or metoclopramide to control emesis | Emesis control was significantly better in ondansetron; global QOL decreased more with metoclopramide. |
Ritz et al. [226] | 2000 | Advanced nursing care (APN)+ standard care vs. standard care | APN improved some QOL indicators. |
Molenaar et al. [227] | 2001 | Decision support to help patients to choose mastectomy or breast conservation | Decision-making improved as evaluated in terms of satisfaction and QOL. |
Sammarco [228] | 2001 | Perceived social support and uncertainty in younger breast cancer survivors | Significant positive correlation between perceived social support and QOL, and significant negative correlation between uncertainty, and QOL. |
Michael et al. [229] | 2002 | Social networks | Pre-diagnosis level of social integration was important factor in future QOL, and explains more of the variance than treatment or tumour characteristics. |
Olsson et al. [230] | 2002 | Erythropoietin (randomized to two different doses epoetin-beta) for treatment of anemia | Global QOL was significantly improved and there was no difference between two study arms. |
O'Shaughnessy [231] | 2002 | Effects of epoetin-alfa to prevent neuronal apoptosis vs. placebo | Improved cognitive function, mood and QOL in treatment group. |
Graves et al. [232] | 2003 | 8-week intervention based on social cognitive theory vs. standard care | Women in intervention group improved more on QOL, mood, self-efficacy, and outcome expectations. |
Courneya et al. [233] | 2003 | Exercise training (randomized trial) | Exercise training had beneficial effects on QOL. |
Turner [234] | 2004 | Seated exercise | Reduced fatigue and improved QOL observed. |
Headley et al. [235] | 2004 | Effect of seated exercise vs. control | Women with advanced breast cancer randomized to the seated exercise had a slower decline in total physical well-being and less increase in fatigue. |
Weinfurt et al. [236] | 2004 | Zoledronic asid or pamidornate disodium for metastatic bone lesion | Overall increase in QOL was observed. |
Diel et al. [237] | 2004 | Ibandronate vs. placebo in breast cancer with metastatic bone pain | A significant improvement in QOL was observed in intervention group; fatigue and pain were also reduced. |
Body et al. [238] | 2004 | Ibandronate vs. placebo in breast cancer with metastatic bone pain | Oral ibandronate had beneficial effects on bone pain and QOL and was well tolerated. |
Wardley et al. [239] | 2005 | Zoledronic acid in community setting vs. hospital setting in breast cancer patients with bone metastases | No difference between settings; safety and QOL benefits were observed. |
Yoo et al. [240] | 2005 | Muscle relaxation training and guided imagery vs. control | Less anticipatory and post-chemotherapy nausea and vomiting and higher QOL in intervention group. |
Manning-Walsh [241] | 2005 | Relationships between persona land religious support and symptom distress and QOL | Personal support was positively related to QOL and had partial mediated effects on symptom distress but religious support was not. |
Gordon et al. [242] | 2005 | Home-based physiotherapy or group-based exercise or no intervention | Physiotherapy was found beneficial for functioning, physical and overall QOL. |
Kendall et al. [243] | 2005 | Influence of exercise (13.2 years following diagnosis) | High level of functioning was observed; those whose exercise increased, maintained a better QOL. |
Chang et al. [244] | 2005 | Effect of weekly epoetin alfa on maintaining hemoglobin levels, and reduction of transfusion vs. standard care | Epoetin alfa improved QOL, maintained hemoglobin levels and reduced of transfusion. |
Hudis et al [245] | 2005 | Effect of weekly epoetin alfa on hemoglobin levels | Epoetin alfa improved hemoglobin levels, and QOL in mildly anemic patients. |
Badger et al. [246] | 2005 | Telephone interpersonal counseling (TPC) vs. usual care | TIP-C was partially effective in symptom management and improved QOL. |
Cheema and Gual [247] | 2006 | Full-body exercise training (before and after evaluation study) | Significant improvements were observed in upper- and lower-body strength, endurance, and QOL. |
Sutton and Erlen [248] | 2006 | Mutual dyadic support intervention | Most dyadic relationships were supportive, some reciprocal and some experienced conflicts. |
Round et al. [249] | 2006 | Recovery advice to prevent treatment problems | Recovery advice given to women neither was supported nor refuted to be able improve QOL. |
Giese-Davis et al. [250] | 2006 | Peer counseling intervention (newly diagnosed and peer counselors) | Significant improvement in newly diagnosed was observed in trauma symptoms, emotional well-being, and self-efficacy but increased emotional suppression and declined QOL in peer counselors. |
Moadel et al. [251] | 2007 | Effects of yoga on QOL | Yoga was associated with beneficial effects on social functioning among breast cancer survivors. |
Hartmann et al. [252] | 2007 | Effects of a step-by-step inpatient rehabilitation programme and QOL | Although not generally superior to conventional inpatient rehabilitation programmes, the step-by-step rehabilitation provided marked benefits for patients with cognitive impairments. |
Kim et al. [253] | 2007 | Effect of complex decongestive therapy (CDT) on edema and QOL in breast cancer patients with unilateral leymphedema | CDT for upper limb lymphedema resulted in significant improved edema and QOL. |
Symptoms
Author (s) [Ref.] | Year | Main focus | Results/conclusion(s) |
---|---|---|---|
Hann et al. [254] | 1998 | Fatigue following radiotherapy | Women experienced fatigue but not worse than expected. |
Carpenter et al. [255] | 1998 | Hot flushes | 65% (n = 114) reported ht flushes, with 59% of women with hot flushes rating the symptom as severe; hot flushes were most severe in women with a higher body mass index, those who were younger at diagnosis, and those receiving tamoxifen. |
Hann et al. [256] | 1999 | Fatigue after high-dose therapy and autolougous stem cell rescue | Fatigue was related to medical and psychosocial factors. |
Velanovich and Szymanski [257] | 1999 | Lymphedema | Lymphedema occurred in a minority of patients and negatively affected QOL. |
Bower et al. [258] | 2000 | Fatigue, occurrence, and correlates | About one-third (n = 1957) reported more severe fatigue which was associate with higher level of depression, pain, and sleep difficulties. |
Kuehn [259] | 2000 | Surgery related symptoms following ALND | Shoulder-arm morbidity following ALND was found to be the most important long-term sources of distress. |
Stein et al. [260] | 2000 | Hot flushes | Hot flushes have a negative impact on QOL that may be due to fatigue and interference with sleep. |
Beaulac et al. [261] | 2002 | Lymphedema in survivors of early-stage breast cancer | MAS or BCS patients had similar lymphedema rates (28%–42/151) and had negative impact on long-term QOL in survivors. |
Kwan et al. [262] | 2002 | Arm morbidity after curative breast cancer treatment | Symptomatic patients and patients with lymphedema had impaired QOL compared to patients with no symptoms. |
Fortner et al. [263] | 2002 | Sleep difficulties | Most patients had significant sleep problems that frequently being disturbed by pain, nocturia, feeling too hot, and coughing or snoring loudly; patients having significant sleep problems had greater deficits in QOL. |
Engel et al. [264] | 2003 | Arm morbidity | Up to 5 years after diagnosis 38% (n = 990) were still experienced arm problems and for these patients QOL was significantly lower than patients without arm morbidity; extent of axilla, younger age, and operating clinic significantly contributed to arm morbidity. |
Caffo et al. [265] | 2003 | Pain after surgery | Pain distressed 40% of patients (n = 529) regardless of treatment type and had negative effect on patients' QOL. |
Rietman et al. [266] | 2004 | Impairments and disabilities (2.7 years after surgery) | Pain was the most frequent assessed impairment after breast cancer treatment with strong relationship to perceived disability and QOL. |
Schults et al. [267] | 2005 | Menopausal symptoms | Menopausal signs and symptoms may not be different or the breast cancer survivors and they should not be confused with the QOL/psychosocial issues of the cancer survivors. |
Ridner [268] | 2005 | Lymphedema | Survivors with lymphedema reported poorer QOL; a symptom cluster including limb sensation, loss of confidence in body, decreased physical activity, fatigue and psychological distress was identified. |
Conde et al. [269] | 2005 | Menopausal symptoms | Prevalence of menopausal symptoms was similar in women with and without breast cancer; sexual activity was less frequent in breast cancer patients. |
Burckhardt et al. [270] | 2005 | Pain | Widespread pain significantly caused more experience of pain severity, pain impact and lower physical health than regional pain. |
Mills et al. [271] | 2005 | Fatigue | Pre-chemotherapy and chemotherapy induced inflammation were related to fatigue and QOL. |
Massacesi [272] | 2006 | Effects of endocrine related symptoms in breast cancer who had switched from tamoxifen to anastrozole | Endocrine related symptoms improved but higher rate of mild arthritic and bone pain were reported. |
Land et al. [273] | 2006 | Tamoxifen or raloxifene related symptoms | No significant differences between groups; tamoxifen group reported better sexual function, more gynecological problems and vasomotor symptoms while raloxifene group reported more musculoskeletal problems and weight gain. |
Heidrich et al. [274] | 2006 | Symptoms, and symptom beliefs in older breast cancer patients vs. older women without breast cancer | Symptom experience and QOL of older breast cancer survivors were similar to those of older women with other chronic health problems. |
Gupta et al. [275] | 2006 | Menopausal symptoms | 96% reported vasomotor, 83% psychological and 90% somatic symptoms (n = 200) which negatively correlated not only their own but also with their partners' QOL. |
Byar et al. [276] | 2006 | Fatigue | Fatigue was associated with other physical and psychological symptoms and higher fatigue compromised QOL. |
Arndt et al. [277] | 2006 | Fatigue | Fatigue emerged as the strongest predictor of QOL. |
Pyszel et al. [278] | 2006 | Disability, and psychological distress in breast cancer survivors with and without lymphedema | Patients with arm lymphedema were more disabled, experienced a poorer QOL and had increased psychological distress in comparison to those without lymphedema. |
Dagnelie et al. [279] | 2007 | Fatigue | Of all QOL domains/subscales, fatigue is by far the predominant contributor to patient-perceived overall QOL in breast cancer patients preceding high-dose radiotherapy. |
Janz et al. [280] | 2007 | Relationship between symptoms and post-treatment QOL | Five most common symptoms were: systemic therapy side effects, fatigue, breast symptoms, sleep difficulties, and arm symptoms. Fatigue had the greatest impact on QOL. |