Quality of life in patients with breast cancer with neoadjuvant chemotherapy: a systematic review

Abstract

ObjectivesThe aims of this systematic review were to assess the impact of neoadjuvant chemotherapy (NAC) on breast cancer (BC) patients’ quality of life (QOL), to compare the different regimens of NAC on BC patients’ QOL, to compare NAC versus adjuvant chemotherapy on BC patients’ QOL and to identify predictors of QOL on patients with BC receiving NAC.DesignThe design used Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.Data sourcesCinahl, Embase, Pubmed, Scopus, Web of Science, Cochrane library and PsycINFO were searched through 27 December 2021.Eligibility criteria for selecting studiesThe inclusion criteria were included: patients with BC receiving NAC, outcome measures related to QOL and published in English. The exclusion criteria were included: duplicates or overlapping participants, not original research, data or full text not available and qualitative study.Data extraction and synthesisTwo independent reviewers used standardised methods to search, screen and code included studies. The risk of bias in individual studies was evaluated with Cochrane collaboration’s tool for assessing risk bias, Newcastle Ottawa Score or Joanna Briggs Institute Critical Appraisal tool. This systematic review performs narrative synthesis based on several different themes.ResultsThe initial search resulted in 2994 studies; 12 of these studies fulfilled inclusion criteria. There was no significant difference in the QOL of BC before and after NAC, but patients experienced adverse reactions and depression during chemotherapy. Different regimens of NAC have different effects on patients’ QOL. Patients with NAC had more severe physical discomfort than those with adjuvant chemotherapy. However, BC patients’ QOL can be improved by intervening on social or family support, and these predictors, including chronotype, QOL before NAC and depression.ConclusionsMore original research is needed in future to understand the profile and predictors of QOL in patients with BC on NAC, which will help clinicians and patients make decisions and deal with NAC-related issues.

Predictors of recurrence in breast cancer patients with pathological partial response

“…Neoadjuvant chemotherapy (NAC) is the standard approach for managing locally advanced breast cancer (LABC) (stages IIB and III) 1 , 2 . NAC downstages tumors by allowing breast-conserving surgery (BCS) instead of mastectomy and avoids axillary lymph node dissection (ALND)-associated lymphedema by allowing sentinel lymph node biopsy (SLNB) 1 - 3 .…”

Dkk1 as a Prognostic Marker for Neoadjuvant Chemotherapy Response in Breast Cancer Patients

“…The primary goal of neoadjuvant chemotherapy (NACT) is to increase the likelihood of breast conservation and possibly avoid axillary dissection in patients who are unwilling to have extensive surgery. It can also give oncologists more information about tumour chemosensitivity, allowing them to avoid ineffective treatments and improve prognosis [5]. The use of specific inhibitors in NACT affects both the tumour cells and tumour microenvironment by activating the priming phase of immunity and effector phase within each, respectively.…”

Fatigue and quality of life during neoadjuvant chemotherapy of early breast cancer: a prospective multicenter cohort study

“…Few and relatively small studies on CRF and HRQoL dimensions have been performed with early breast cancer patients during neoadjuvant chemotherapy [ 12 , 13 , 15 , 16 ], which is why further evaluation of CRF and HRQoL in this population is needed. Their development might differ from that of the adjuvant setting, as surgery has been shown to worsen CRF and HRQoL [ 17 ] and thereby alter the patient’s perception of both endpoints during chemotherapy [ 11 ].…”