Quality of Life in Early Breast Cancer Patients: A Prospective Observational Study Using the FACT-B Questionnaire

Abstract

Background/Aim: Quality of life (QoL) in early breast cancer (BC) treatment may be affected by acute and late toxicities. This study evaluated the impact of radiotherapy (RT) schedules, treatment-related toxicities, hormone therapy (HT) and age on QoL. Patients and Methods: Ninety-five patients answered the FACT-B 4.0 questionnaire. Acute or late toxicities were recorded at each follow-up visit. Results: The median trend of the QoL subscales was stable during all questionnaires. HT negatively impacted on Functional Assessment of Cancer Therapy-General-Total, functional and emotional wellbeing. No difference was recorded between RT schedules and toxicity. No significant differences for age were detected in QoL. Conclusion: RT seems not to influence QoL of BC patients, in terms of fractionation regimen or RT-related side-effects. Moreover, women having systemic HT experienced a QoL worse than patients treated with RT only. Further and longterm protocols are needed to improve the validity of the tool.Advances in diagnosis and treatment of breast cancer (BC) have led to an increase in cancer survival, resulting in quality of life (QoL) improvement. Breast conserving surgery followed by adjuvant radiation therapy (RT) is the current standard treatment for early BC. Local and systemic treatments could cause skin dyschromia, lymphedema, fatigue, hot flashes, sexual dysfunction, and arthralgia with consequent changes in physical appearance and routine activities. These toxicities may persist for a long time after treatment with a subsequent decline in QoL (1). Studies have shown that in clinical trials QoL represents an important endpoint, whose assessment could contribute to improved treatment and patient's satisfaction (2-5). Under this scenario, the main aim of the study was to evaluate the impact of RT and hormone therapy (HT) on the QoL during the first 2 years after RT. Fractionation schedules (conventional vs. hypofractionation), radiation toxicities and age were also investigated. QoL was evaluated with Functional Assessment of Chronic Illness Therapy General Questionnaire and its Breast Cancer Supplement (FACT-B) questionnaire (https://www.facit.org), version 4.0 in Italian language. This tool is deemed as a quick and well validated multi-dimensional self-report questionnaire with subscales measuring physical, social, emotional, and functional wellbeing and contains additional concerns in breast cancer (6). Patients and MethodsThe study was designed as a prospective observational research project and was approved by the Ethics Committee of the "SS Annunziata" Hospital, "G. D'Annunzio" University, Chieti, Italy on 9 th May 2018. All patients were treated in our Radiotherapy Department and provided written informed consent. Medical records of enrolled patients were marked by a pink circle to streamline the identification process during treatment and follow-up.Inclusion criteria were: female patients, age ≥18 years, histologically proven breast cancer, ductal carcinoma in situ and invasive carcinoma stage I-II, bre...

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