Quality of life changes during the pre- to postdiagnosis period and treatment-related recovery time in older women with breast cancer

Authors

  • Angela M. Stover MA,

    Corresponding author
    1. Health Behavior, University of North Carolina–Chapel Hill, Chapel Hill, North Carolina
    2. Lineberger Comprehensive Cancer Center, University of North Carolina–Chapel Hill, Chapel Hill, North Carolina
    3. Cecil G. Sheps Center for Health Services Research, University of North Carolina–Chapel Hill, Chapel Hill, North Carolina
    • Corresponding author: Angela M. Stover, MA, Department of Health Behavior, CB #7440, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7411; Fax: (919) 966-2921; stoveram@email.UNC.edu

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  • Deborah K. Mayer PhD, RN, AOCN, FAAN,

    1. Lineberger Comprehensive Cancer Center, University of North Carolina–Chapel Hill, Chapel Hill, North Carolina
    2. School of Medicine, University of North Carolina–Chapel Hill, Chapel Hill, North Carolina
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  • Hyman Muss MD,

    1. Lineberger Comprehensive Cancer Center, University of North Carolina–Chapel Hill, Chapel Hill, North Carolina
    2. School of Medicine, University of North Carolina–Chapel Hill, Chapel Hill, North Carolina
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  • Stephanie B. Wheeler PhD, MPH,

    1. Lineberger Comprehensive Cancer Center, University of North Carolina–Chapel Hill, Chapel Hill, North Carolina
    2. Health Policy and Management, University of North Carolina–Chapel Hill, Chapel Hill, North Carolina
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  • Jessica C. Lyons MS,

    1. Lineberger Comprehensive Cancer Center, University of North Carolina–Chapel Hill, Chapel Hill, North Carolina
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  • Bryce B. Reeve PhD

    1. Lineberger Comprehensive Cancer Center, University of North Carolina–Chapel Hill, Chapel Hill, North Carolina
    2. Health Policy and Management, University of North Carolina–Chapel Hill, Chapel Hill, North Carolina
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Abstract

BACKGROUND

Health care providers have little population-based evidence about health-related quality of life (HRQOL) changes, from the pre- to postdiagnosis period, and treatment-related recovery time for women aged 65 years and older diagnosed with breast cancer.

METHODS

Older women with and without breast cancer completed self-reports of HRQOL at baseline and 2 years later as part of annual Medicare Health Outcomes Surveys (MHOS). MHOS was linked to Surveillance, Epidemiology, and End Results registries, which were used to categorize women with breast cancer by treatment type (breast-conserving surgery, breast-conserving surgery plus radiation, mastectomy) and time since diagnosis at follow-up. Each cancer case diagnosed in 1998 through 2007 (N = 542) was matched to 5 women without cancer (N = 2710) using propensity score matching. Analysis of covariance models examined changes in HRQOL, adjusting for demographics and initial functioning.

RESULTS

Older women within 6 months of diagnosis had greater declines than women without cancer in SF-36 Physical (−5.8 vs −1.8) and Mental (−3.6 vs −0.7) Component Summary scores, General Health (−12.3 vs −4.6), Vitality (−11.0 vs −2.2), Bodily Pain (−8.5 vs −2.1), Social Functioning (−15.1 vs −3.3), Role-Physical (−26.5 vs −3.9), and Role-Emotional (−13.1 vs −3.1) scores (all P < .05). By approximately 1 year, women with and without breast cancer had similar HRQOL. Comparable declines in Physical Component Summary and Role-Physical occurred across treatment types.

CONCLUSIONS

Women aged 65 years and older diagnosed with breast cancer should be counseled that survivors within 6 months of diagnosis are vulnerable to HRQOL declines, compared to women without breast cancer, but that decrements generally wane after 12 months. Cancer 2014;120:1881–1889. © 2014 American Cancer Society.

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