One-year recovery from breast cancer: Importance of tumor and treatment-related factors, resilience, and sociodemographic factors for health-related quality of life

Abstract

AimThis study investigated the changes in health-related quality of life from diagnosis to 1 year after diagnosis in breast cancer (BC) patients and the influence of clinical, psychological, and sociodemographic variables. An additional aim was to explore the mediating and moderating effects of resilience on changes in health-related quality of life.MethodsA longitudinal population-based study was conducted in southern Sweden. Newly diagnosed BC patients filled in measures of health-related quality of life, resilience, and sociodemographic variables at diagnosis (N = 980) and 1 year post-diagnosis (N = 780). Clinical variables were extracted from the Swedish national breast cancer quality registry. Mixed-model analyses were performed.ResultsMost health-related quality of life outcomes declined from diagnosis to 1 year post-diagnosis. Role limitations due to emotional problems remained the same, whereas mental health improved. Lower health-related quality of life outcomes were associated with symptomatic detection and axillary dissection. Patients with a higher TNM stage and histologic grade and estrogen receptor (ER)-negative and human epidermal growth factor 2 (HER2)-positive status, who received chemotherapy, antibody therapy, or bisphosphonate therapy, had a steeper decline in outcomes. Changes in resilience were positively associated with all outcomes but did not mediate or moderate changes in any. Resilience at baseline moderated changes in bodily pain, vitality, and mental health, with higher baseline resilience being associated with a steeper decline, possibly due to floor or ceiling effects. Patients with lower socioeconomic status, educational level, and older age had a lower health-related quality of life.ConclusionPhysical health-related quality of life among breast cancer patients declined 1 year post-diagnosis, whereas mental health-related quality of life improved. Low resilient patients may be especially vulnerable at diagnosis. Biopsychosocial assessment at diagnosis can help identify patients who may require additional support. A multidimensional treatment plan should be started early to help overcome the problems in everyday activities.

Associations among early health-related quality of life, mental resilience, and social support in patients after surgery for osteoporotic vertebral compression fractures: a longitudinal study

“…As a dynamic construction, mental resilience is de ned as an individual's ability to face adverse, stressful and traumatic events and overcome them in an e cient way 10 . Enhancing mental resilience have a positive impact on patients' overall well-being by improving their ability to manage adverse emotions and experiences, ultimately enabling them to confront with the comprehensive treatment adeptly 11 . When facing with the challenges of diseases, individuals are able to adjust to them in a positive way, ultimately acquiring an improved quality of life 12 .…”

The Impact of Newly Diagnosed Early Breast Cancer on Psychological Resilience, Distress Levels, and the Perception of Health

“…Regarding patients with cancer, including BC patients, resilience refers to an individual’s protective mechanisms and personal characteristics which are amendable and can promote the successful adaptation to a cancer diagnosis [ 8 ]. Higher resilience levels are found to be associated with lower levels of distress, better QoL, better tolerance of treatment side effects and cancer-related fatigue [ 21 , 22 , 23 , 24 , 25 , 26 ], better body image, less depression and anxiety, and less severe adverse effects of systemic anti-cancer treatment [ 27 , 28 ]. Regarding sociodemographic characteristics, male sex, older age, and a higher education level are positively related to resilience in some studies while inversely associated in others [ 8 , 20 , 21 , 23 ].…”

“…Still, studies on resilience in BC patients had a wide heterogeneity of the BC patients. While some studies assessed the resilience of EBC patients during active oncology treatment [ 25 , 26 , 27 , 29 , 35 ], others assessed resilience among BC survivors [ 17 , 28 , 31 , 32 , 35 , 36 ], and few combined early and metastatic BC patients [ 15 , 16 , 24 , 37 ]. Furthermore, very few studies were designed with a control group [ 29 , 32 , 33 , 35 , 38 ], or included a BC group that consisted of early and metastatic BC patients.…”

Predictive Models of Psychological Distress, Quality of Life, and Adherence to Medication in Breast Cancer Patients: A Scoping Review

“…In summary, a complex interplay of clinical and psychosocial variables plays a relevant role in BC patients' clinical trajectories, shaping their experiences with the disease and affecting their QoL. 12,[23][24][25][26] Several studies investigated sociodemographic, clinical, and psychosocial factors that might influence the subjective variability observed in BC patients on psychological distress, QoL, and adherence. Several predictive models have been developed through different statistical methods (eg, linear regression, logistic regression, structural equation modeling); [27][28][29][30][31] some of these models have been further validated in additional samples, testing the model in other groups, 28,31 and they have been eventually applied in clinical practice, particularly in patients' assessment.…”