Psychosocial, lifestyle-related factors affect breast cancer quality of life

Key takeaways:

• Women with breast cancer who reported deteriorating quality of life had worse scores 1 year after diagnoses.
• Psychosocial and lifestyle-related factors were tied to breast cancer quality of life deterioration.

Deteriorating quality of life for women with breast cancer was associated with many common modifiable psychosocial and lifestyle-related factors, according to an analysis published in JAMA Network Open.

“Cancer contributes greatly to the global burden of chronic illness and has a tremendous impact [on] patient’s quality of life, including physical, emotional and social domains,” Maria Alice Franzoi, MD, a faculty member of the Breast Cancer Survivorship Group at Gustave Roussy, France, and colleagues wrote. “The impact that cancer and its treatment have on an individual’s health trajectory can vary substantially, meaning that some patients require more care resources than others.”

Franzoi and colleagues conducted a longitudinal analysis of quality of life utilizing data from the CANTO study, a large, national, prospective cohort of 10,792 women (mean age, 56.3 years) with stage I to III breast cancer treated from 2012 to 2018 in France. Using the European Organisation for Research and Treatment of Cancer (EORTC) 30-item Quality of Life Questionnaire (QLQ-C30) summary score, with higher scores equaling better quality of life (QOL), researchers assessed QOL at diagnosis and 1, 2, 4 and 6 years after breast cancer diagnoses.

Overall, 45.8% of women were categorized as having excellent QOL, 33.3% as very good, 16.1% as deteriorating and 4.8% as poor. Women in the deteriorating group reported good baseline QOL, with a score of 73.3, which significantly worsened to a score of 63 by the first year after diagnosis and continued worsening, with a final score of 64.7 at year 6.

Researchers identified the following factors associated with deteriorating QOL for women with breast cancer:

• younger age (adjusted OR = 1.1; 95% CI, 1.05-1.16);
• overweight (aOR = 1.9; 95% CI, 1.6-2.25);
• obesity (aOR = 1.25; 95% CI, 1.07-1.46);
• physical inactivity (aOR = 1.13; 95% CI, 1.04-1.35);
• current smoking (aOR = 1.16; 95% CI, 0.98-1.36);
• former smoking (aOR = 2.14; 95% CI, 1.8-2.54);
• Charlson Comorbidity Index score of one or greater (aOR = 1.56; 95% CI, 1.33-1.83);
• lower monthly household income of less than 3,000 euros (aOR = 1.5; 95% CI, 1.3-1.72);
• receipt of adjuvant chemotherapy (aOR = 1.35; 95% CI, 1.14-1.59); and
• receipt of adjuvant endocrine therapy (aOR = 1.46; 95% CI, 1.22-1.75).

“Our results could be used to facilitate the creation of personalized, proactive and preventive supportive care pathways by targeting at-risk patients at diagnosis,” the researchers wrote. “The efficacy of such pathways to prevent QOL deterioration, as well as the best implementation and care delivery model, should be investigated.”