From: A systematic review of quality of life instruments in long-term breast cancer survivors
Study | Study objective | Patient population | Inclusion/exclusion criteria | Instruments used/ Administration | Results | Ferrell's QoL domains * |
---|---|---|---|---|---|---|
Dow et al. (1996) [28] | Evaluation of QoL in long-term BCS. | N = 294; mean post-cancer survivorship = 68.5 months; mean age = 50.9 years. | Not reported | QOL-CS, FACT-G Self-administered | Concerns included psychological/family distress, fear of recurrence, uncertainty, fatigue, chest pain, sleep problems, and sexuality. | Ph. Ps. So. Sp. |
Weitzner et al. (1997) [29] | Comparison of mood and QoL of BCS with those observed in low-risk breast cancer screening patients. | Long-term stage I-III BCS (N = 60); mean age = 53.8 years. Low-risk breast cancer screening patients (N = 93); mean age = 45.3 years. Mean post-cancer survivorship ≥ 5 years. | Inclusion (BCS): disease-free ≥ 5 years; stage I, II, or III; age < 70 years. Inclusion (comparison group): no personal/family history of breast cancer. Exclusion (both groups): DSM-III-R psychiatric diagnosis; brain carcinoma; using steroids/narcotic analgesics. | QLI-CV; other instruments (BDI, STAI) Self-administered | Stage III breast cancer resulted in significantly poorer functioning compared to other groups. | Ps. So. |
Ashing-Giwa et al. (1998) [30] | Evaluation of QoL of long- term BCS and to examine the role of ethnicity. | African-American: N = 117; mean post-cancer survivorship = 6.5 years; White respondents: N = 161); mean post-cancer survivorship = 7.4 years. | Inclusion: breast carcinoma diagnosis between 1989 and 1990; previously participated in a study of first-degree relatives of BCS by Bastani et al. | CARES-SF; other instruments (SF-36, Ladder of Life Scale, Life Distress Scale). Self-administered | Overall, BCS reported favorable health-related QoL. Differences in QoL outcomes were attributable to socioeconomic and life-burden factors and not to ethnicity. | Ph. So. |
Holzner et al. (2001) [31] | Evaluation of effect of time elapsed since initial diagnosis on QoL. | N = 87; mean post-cancer survivorship = 5.1 years; mean current age = 53.9 years. | Inclusion: Relapse-free patients. Exclusion: presence of other severe diseases. | EORTC QLQ-C30, EORTC QLQ-BR23, FACT-B. Self-administered | Emotional, social, and sexual functioning areas showed reduced QoL after initial treatment (1-2 years) and > 5 years survival. | Ps. So. |
Beaulac et al. (2002) [32] | Evaluation of effect of surgical treatment related lymphedema on QoL. | Women with lymphedema, (N = 42), without lymphedema (N = 109); mean post-cancer survivorship = 5.0 years; mean age = 62.4 years. | Inclusion: mastectomy or breast-conserving surgery with radiation; level I, II axillary lymph node dissection. Exclusion: other breast surgery; chemotherapy; rheumatologic condition. | FACT-B. Self-administered | Women with lymphedema reported lower breast, functional, and physical wellbeing, irrespective of type of surgery. | Ph. Ps. So. |
Cimprich et al. (2002) [33] | Evaluate relationship between life-stage variables on QoL in BCS. | Diagnosis age: young (< 45 years, N = 42), middle (45-65 years, N = 35), old (> 65 years, N = 28); mean post-cancer survivorship = 11.5 years. | Inclusion: at least 5 years past the diagnosis; no recurrent disease or other cancer diagnosis. | QOL-CS Self-administered | Long-term BCS diagnosed at an older age had worse QoL in physical domain and women diagnosed at a younger age had worse QoL in social domain. | Ph. Ps. So. |
Kornblith et al. (2003) [34] | Assessing the long-term impact of breast carcinoma in BCS. | Phase III randomized trial CALGB 7581] group; N = 153; mean post-cancer survivorship = 18 years; age (range) = 41-87 years. | Inclusion: no evidence of breast carcinoma; completion of all cancer treatment at least1 year interview; no major psychiatric/cognitive deficit. | EORTC QLQ-C30; other instruments (BSI, LES, OARS, PCL-C). nterviewer-administered | Persistent psychological effects were observed in BCS long after treatment completion. | Ph. Ps. So. |
Sammarco et al. (2003) [35] | Evaluation of relation among social support, uncertainty, and QoL in older BCS. | Older women (> 50 years); N = 103; mean post-cancer survivorship = 5.0 years; mean age = 68 years. | Inclusion: > 50 years; able to read and respond in English. | QLI-CV; other instruments (SSQ, MUIS-C). Self-administered | There was significant association between perceived social support and QoL. Uncertainty resulted in poorer QoL. | Ph. Ps. So. Sp. |
Casso et al. (2004) [36] | Assessing QoL of long-term BCS diagnosed at age of 40-49 years. | N = 216; mean post-cancer survivorship = 7.3 years; age (range) = 45-60 years. | Inclusion: women with an initial diagnosis of ductal carcinoma in situ (DCIS) or invasive breast cancer; diagnosis age of 40-49 years. | CARES-SF; other instruments (SF-36, CES-D). Self-administered | Long-term QoL affected by surgery/chemotherapy/hormonal therapy. Negative impact of breast related symptoms/pain on QoL. | Ph. So. |
Ahles et al. (2005) [37] | Comparison of local therapy and standard-dose systemic chemotherapy on BCS's QoL. | Women treated with standard-dose systemic chemotherapy (N = 141, mean age = 57 years) or local therapy (N = 294, mean age = 65.8 years); mean post-cancer survivorship = 10.0 years. | Inclusion: > 5 years after diagnosis; currently disease free; currently receiving no cancer treatments. | QOL-CS. Interviewer-administered | Survivors treated with systemic chemotherapy exhibited lower overall QoL compared with survivors treated with local therapy only. | Ph. Ps. So. |
Burckhardt et al. (2005) [38] | Evaluation of effect of chronic pain on health status and overall QoL resulting from surgical treatment. | Women with regional pain: N = 11; mean post-cancer survivorship = 5.9 years; mean age = 58.7 years and with widespread pain: N = 12; mean post-cancer survivorship = 5.4 years; mean age = 56.8 years. | Inclusion: post-mastectomy ≥ 6 months/≥ 3 months post-radiation/cytotoxic chemotherapy; cancer-free; simple mastectomy/lumpectomy/modified radical mastectomy. Exclusion: breast surgery for cosmetic reasons or prophylactic mastectomy; arthritis. | FACT-B, QOLS; other instruments (BPI, MPQ-SF, FIQ, SF-36). Self-administered | Women who experienced widespread pain after breast cancer surgery had significantly more severity of pain and lower physical health status than those with regional pain. | Ph. Ps. So. |
Helgeson et al. (2005) [39] | Examining the impact of breast cancer on long-term QoL. | Survivors, N = 267, mean age = 54.4 years. Controls, N = 187, mean age = 53.2 years; mean post-cancer survivorship = 5.5 years. | Inclusion: Women with Stage I, II, or III breast cancer who underwent surgery followed by adjuvant chemotherapy between 1993 and 1996. | FACIT-SP, MFSI; other instruments (SF-36, PANAS, BSI, DAS, IES). Interviewer-administered | Survivors reported more difficulties with physical functioning and more physical symptoms. | Ph. So. |
Carver et al. (2006) [40] | Assessing the effect of medical, demographic, and personal variables on BCS's QoL. | N = 163; mean post-cancer survivorship = 10.0 years; mean age at diagnosis = 54.2 years. | Inclusion: Women who participated in the past projects (1988-1995, 1994-1996). | QLACS; other instruments (LOT, ISEL). Self-administered | Initial chemotherapy and higher stage predicted more financial problems and worry about appearance. More distress and social avoidance in Hispanic BCS. | Ph. Ps. So. |
Dirksen et al. (2007) [41] | Evaluation of efficacy of cognitive behavioral therapy on fatigue, mood, and QoL in BCS. | N = 86; mean post-cancer survivorship, CBT group = 85.3 months & control = 63.8 months; mean age = 58 years. | Inclusion: stage I, II or III, ≥ 3 months post-treatment; disease-free; sleep problem ≥ 3 months. Exclusion: cognitive impairment or other sleep disorders (restless leg syndrome). | FACT-B; other instruments (STAI, CES-D, POMS). Self-administered | Women receiving cognitive behavioral therapy for insomnia had significant improvements in fatigue, trait anxiety, depression and QOL. | Ph. Ps. So. |
Perkins et al. (2007) [42] | Evaluation of individual differences in well-being in older BCS. | N = 127; mean post-cancer survivorship = 5.1 years; mean age = 78.2 years. | Inclusion: BCS survivors with a current age of 70 or older. | FACIT-SP, FSI; other instruments (SF-36, LOT-R). Self-administered | Higher age predicted increased depression. Poorer health status was associated with poorer well-being. | Ph. Ps. So. Sp. |
Leak et al. (2008) [43] | Examining relation among symptom distress, spirituality, and QoL of African- American BCS. | N = 30; mean post-cancer survivorship = 5.6 years; mean age 55.5 years. | Inclusion: speak and read English; had diagnosis of breast cancer; treatment completion (Jan 1, 1980 - June 1, 2004). Exclusion: recurrent breast cancer/another cancer in the past 12 months. | QLI-CV; other instruments (SDS, SPS). Interviewer -administered | Sleep disturbance, fatigue, and pain were the most commonly reported symptoms in African- American BCS. | Ph. Ps. So. Sp. |
Sammarco et al. (2008) [44] | Examining relation among perceived social support and uncertainty on Hispanic BCS's QoL. | N = 89; mean post-cancer survivorship = 5.0 years; age (range) = 30-86 years. | Inclusion: at least one year after treatment. | QLI-CV; other instruments (SSQ, MUIS-C). Self-administered | Perceived social support and uncertainty play a pivotal role in managing or maintaining QoL in Hispanic BCS. | Ph. Ps. So. Sp. |
Skrzypulec et al. (2008) [45] | Evaluate problems related to total and partial mastectomy affecting QoL. | Treatment with total mastectomy (N = 403, mean age = 57.8 years); partial mastectomy (N = 91, mean age = 47.3 years); post-cancer survivorship = 6-10 years. | Inclusion: total mastectomy due to breast cancer (research group); partial mastectomy (control group). Exclusion: using drugs impeding sexual function. | EORTC QLQ-BR23; other instruments (IES, LSI, HADS). Self-administered | The level of depression and anxiety in women after mastectomy results in worse bio-psychosocial functioning. | Ph. So. |
Speck et al. (2010) [46] | Evaluation of impact of Physical Activity and Lymphedema (PAL) trial on perceptions of body image in BCS. | BCS with lymphedema (N = 112); without lymphedema (N = 122). Post-cancer survivorship > 5 years. | Inclusion: unilateral non-metastatic breast cancer; BMI < 50 kg/m2; cancer-free; no medical conditions limiting participation in exercise program; no weight lifting in year prior to study entry, not currently pregnant/lactating. | BIRS Self-administered | Twice-weekly strength training positively impacted self-perceptions of appearance, health, physical strength, sexuality, relationships, and social functioning. | Ph. So. |