The impact of age and clinical factors on quality of life in early breast cancer: An analysis of 2208 women recruited to the UK START Trial (Standardisation of Breast Radiotherapy Trial)
There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.
Abstract
Quality of life (QOL) assessments of women entering a UK randomised trial of adjuvant
radiotherapy (START) were investigated to estimate the independent effects on QOL
of age, time since surgery, type of breast surgery, chemotherapy and endocrine therapy.
QOL was evaluated using the EORTC general cancer QOL scale (EORTC QLQ-C30), breast
cancer module (BR23), the Body Image Scale (BIS) and the Hospital Anxiety and Depression
Scale (HADS). Independent effects of age and clinical factors were tested using multiple
regression analysis. A total of 2208 (mean age 56.9 years, range 26-87) consented
to the QOL study prior to radiotherapy; 17.1% had undergone mastectomy (Mx) and the
remainder had undergone a wide local excision (WLE). 33.3% had received adjuvant chemotherapy
(CT) and 56.7% were taking endocrine therapy (ET). Age had significant effects on
QOL with older and younger subgroups predicting poorer QOL for different domains.
CT affected most QOL domains and resulted in worse body image, sexual functioning,
breast and arm symptoms (<0.001). Mx was associated with greater body image concerns
(p<0.001), and WLE with more arm symptoms (p=0.01). There were no effects of ET on
QOL. Women <50 years (proxy pre-menopausal) had worse QOL in respect of anxiety, body
image and breast symptoms but age and clinical factors had no effect on depression.
Overall, QOL and mental health were favourable for most women about to start RT, but
younger age and receiving CT were significant risk factors for poorer QOL, and so
patients in these subgroups warrant further monitoring. Surgery had a limited impact
and ET had no effect on QOL.