Comparison of younger and older breast cancer survivors and age‐matched controls on specific and overall quality of life domains

Abstract

Background Younger survivors (YS) of breast cancer often report more survivorship symptoms such as fatigue, depression, sexual difficulty, and cognitive problems than older survivors (OS). We sought to determine the effect of breast cancer and age at diagnosis on Quality of Life (QoL) by comparing 3 groups: 1) YS diagnosed at age 45 or before, 2) OS diagnosed between 55 and 70, and, 3) for the YS, age-matched controls (AC) of women not diagnosed with breast cancer. Methods Using a large Eastern Cooperative Oncology Group (ECOG) data base, we recruited 505 YS who were ages 45 or younger when diagnosed and 622 OS diagnosed at 55 to 70. YS, OS, and AC were compared on physical, psychological, social, spiritual, and overall QoL variables. Results Compared to both AC and to OS, YS reported more depressive symptoms (p=.005) and fatigue (p<.001), poorer self-reported attention function (p<.001), and poorer sexual function (p<.001) than either comparison group. However, YS also reported a greater sense of personal growth (p<.001) and perceived less social constraint (p<.001) from their partner than AC. Conclusions YS reported worse functioning than AC relative to depression, fatigue, attention, sexual function, and spirituality. Perhaps even more important, YS fared worse than both AC and OS on body image, anxiety, sleep, marital satisfaction, and fear of recurrence, indicating that YS are at greater risk for long term QoL problems than survivors diagnosed at a later age.

When the Patient Is Also a Carer

“…For a medical oncologist, a patient like that meant that there probably wouldn't be any worries about serious comorbidities or bone marrow reserve during chemotherapy, or about prolonged loss of function afterwards. In fact, it wasn't until more than a decade later, after attending a symposium specifically devoted to the special needs of young patients, that my eyes were suddenly opened to the fact that, compared with their older counterparts, those patients experienced unique, and often more serious, medical and (especially) psychosocial morbidities from their cancer treatment-a situation that held true not only during active treatment, but well beyond [1][2][3] .…”

A comparison of younger and older couples coping with breast cancer : examining the relationship among mutuality, dyadic coping, and quality of life of patients and partners.

“…When compared to older survivors and age-matched controls, younger breast cancer survivors present more cognitive problems and fatigue (Champion et al, 2014).…”

“…higher level of depression, anxiety and fear of recurrence are consistently reported within five years post diagnosis (Champion et al, 2014;Crist & Grunfield, 2013;Hopwood et al, 2007;Howard-Anderson et al, 2012;Ganz et al 2003;Kroenke et al, 2004). In particular, anxiety and depressive symptoms have been found among those who had received chemotherapy and reported low level of support from closed ones and partners (Borstelmann et al, 2015;Gold et al, 2015).…”

“…The literature has consistently revealed that younger women experience significantly higher levels of psychological distress and poorer quality of life compared to patients diagnosed later in life, with particularly worse emotional and social functioning registered both during active treatment and survivorship (Bantema-Joppe et al, 2015;Champion et al, 2014;Cataldo et al, 2013;Hartl et al, 2010;Hau et al, 2013;Luutonen et al, 2011;So et al, 2011).…”

“…Body image and sexual difficulties acquire a significant meaning among younger women, as they often represent the most challenging consequences of treatment and the long term legacy of the illness on individual well-being and close relationships (Bantema-Joppe et al, 2015;Burwell et al, 2008;Champion et al, 2014;Fobair et al, 2006;Geue, Schmidt, Sender, Sauter, & Friedrich, 2015;Hill et al, 2011;Jankowska, 2013).…”