Health-related Quality of Life of Breast Cancer Survivors Attending an Exercise Intervention Study: A Five-year Follow-up

Abstract

Background/Aim: As the number of breast cancer survivors is increasing, their long-term health-related quality of life (HRQoL) has become an important issue. The aim of the study is to follow up the HRQoL of breast cancer survivors (BCS) in a prospective randomized exercise intervention study and to compare HRQoL to that of the agematched general female population. Patients and Methods: Following adjuvant treatment, 537 patients aged 35-68 and capable of exercise training were randomized to a 12-month exercise trial. In 182 of those patients, HRQoL was measured by the generic 15D at baseline and followed up for five years. Furthermore, the HRQoL of all BCS answering the 15D at five-year follow-up (n=390) was compared to that of a representative sample of the general population. Results: After five years, the BCS' mean HRQoL demonstrated a statistically and clinically significant impairment compared to that of the general population (difference-0.023, p<0.001). The mean HRQoL of BCS followed up from baseline until five years did not improve significantly (change=0.007, p=0.27), whereas the dimensions of usual activities (0.043, p=0.004), depression (0.038, p=0.007), distress (0.030, p=0.036), and sexual activity (0.057, p=0.009) did. Conclusion: The HRQoL of BCS was still impaired five years following treatment. The prognosis of breast cancer has improved dramatically during the last decades and this, together with an increasing incidence and an aging population, has led to a greater number of breast cancer survivors (BCS) (1, 2). The improved prognosis of breast cancer is largely due to early detection with comprehensive screening, and advanced surgical and adjuvant treatments. Adjuvant treatments of breast cancer clearly improve patients' survival, however, effective treatments have severe adverse effects that compromise patients' wellbeing (3-5). Consequently, many BCS suffer from numerous long-term cancer-and treatmentrelated adverse effects and impaired health-related quality of life (HRQoL) even years after the diagnosis and treatment (6-9). With an increasing population of BCS, it is essential to investigate their long-term perceived health and wellbeing and to identify those with impairments in HRQoL to be able to focus on their rehabilitation after breast cancer treatment. Studies focusing on HRQoL in breast cancer have often used disease-specific instruments (5, 10). Disease-specific 667 This article is freely accessible online.

Two-year follow-up after a six-week high-intensity training intervention study with breast cancer patients: physiological, psychological and immunological differences

“…Therefore, it was difficult for the patients to integrate HIT/HIRT into daily life on their own. There is only a limited number of studies that followed breast cancer patients over 1-2 years reporting inflammation, performance and well-being and even less, which monitored such data after HIT/HIRT [13].…”

“…Up to now, alternatives to moderate aerobic intensity exercise in cancer therapy like high intensity exercises for strength, endurance or in combination are only rarely examined [11,12]. In addition, there are even fewer studies that followed breast cancer patients over years [13], although it was shown that lifestyle modifications could prevent about one-third of all cases of breast cancer [14]. Adherence to different training regimes also need further examination [15][16][17].…”

Long-term health-related quality of life of breast cancer survivors remains impaired compared to the age-matched general population especially in young women. Results from the prospective controlled BREX exercise study

“…During the intervention (i.e., the first year after adjuvant treatment), the survivors' HRQoL improved in both the intervention and control groups measured with the EORTC QLQ-C30, but no effect of the exercise intervention on HRQoL was detected at one-or five-year follow-ups [13,14]. At five-year followup, the HRQoL of the survivors, measured with the 15D, still remained below the population level [15].…”

IMPROVE, a community‐based exercise intervention versus support group to improve functional and health outcomes among older African American and Non‐Hispanic White breast cancer survivors from diverse socioeconomic backgrounds: Recruitment strategies and baseline characteristics

“…Many studies have examined the ability and effects of dietary and physical activity interventions to change modifiable lifestyle behaviors among breast cancer survivors 3 . These interventions could lead to better cancer and health outcomes, including a reduced risk of breast cancer mortality 4‐6 and improved physical function, fatigue, and quality of life 7‐9 . A meta‐analysis of >12,000 women with breast cancer demonstrated that postdiagnosis physical activity reduced breast cancer mortality by 34% and reduced all‐cause mortality by 41% 10 .…”

“…3 These interventions could lead to better cancer and health outcomes, including a reduced risk of breast cancer mortality [4][5][6] and improved physical function, fatigue, and quality of life. [7][8][9] A meta-analysis of >12,000 women with Cancer June 1, 2021 breast cancer demonstrated that postdiagnosis physical activity reduced breast cancer mortality by 34% and reduced all-cause mortality by 41%. 10 Unfortunately, the study populations for many of these interventions consisted mostly of relatively younger non-Hispanic White (NHW) women.…”