Determinants of Health-related Quality of Life in Breast Cancer Patients: A Comprehensive Study in Marrakech, Morocco

Abstract

Introduction The assessment of quality of life (QoL) has become crucial for evaluating treatment effectiveness and prognosis in oncology, especially in the case of breast cancer, where patients are at a high risk of experiencing reduced QoL during active treatment. The objective of this study is to assess health-related quality of life and examine the socio-economic and clinical factors influencing it in breast cancer patients in the city of Marrakech, Morocco. Methods The study was conducted on 220 breast cancer patients at the Marrakech University Hospital in Morocco. Quality of life was evaluated using the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 and the specific Breast Cancer questionnaire (EORTC-QLQ-BR23). Descriptive statistics, correlation analysis between socio-economic and clinical factors with QoL subscales, and linear regression were performed to analyze the data. Results The results indicated that the mean score for overall health was 60.4%. Social functioning had the highest score (85.8%), while emotional functioning had the lowest (70.4%). Among the symptom scales, the most concerning were fatigue, loss of appetite, pain, and financial difficulties. For QLQ-BR-23, the future perspective was the most affected domain (25.30%), as well as body image (13.79%). Symptom scale scores ranged from 20.4% to 61.6%, with the most concerning symptom being systemic treatment of side effects. The results showed that age (p= 0.011, β= -0.142), disease duration (p = 0.000, β= 0.624), and monthly income (p = 0.000, Β= 0.233) significantly influenced quality of life. Body image was significantly associated with marital status (p= 0.049, β= -0.140) and type of surgery (p = 0.031, β= -0.149). Sexual pleasure was correlated with marital status (p = 0.037, β= 0.191) and radiotherapy treatment (p = 0.021, β= -0.223). Conclusion The study revealed that patients have concerns related to financial difficulties while coping with symptoms associated with their illness. Age, disease duration, and monthly income were found to be the factors influencing the quality of life. Furthermore, body image was affected, as was emotional well-being, emphasizing the importance of addressing psychological aspects in their care by healthcare professionals.