Quality of life of early‐stage breast‐cancer patients diagnosed with COVID‐19 in the first three waves of the epidemic treated in the Spanish region of Navarre

Abstract

Objectives: To describe the Quality of Life (QOL) of breast-cancer patients diagnosed with COVID-19 and analyse its evolution, compare the QOL of these patients according to the COVID-19 wave in which they were diagnosed, and examine the clinical and demographic determinants of QOL. Methods: A total of 260 patients with breast cancer (90.8% I-III stages) and COVID-19 (85% light/moderate) were included (February-September 2021) in this study. Most patients were receiving anticancer treatment (mainly hormonotherapy). Patients were grouped according to the date of COVID-19 diagnosis: first wave (March-May 2020, 85 patients), second wave (June-December 2020, 107 patients) and third wave (January-September 2021, 68 patients). Quality of Life was assessed 10 months, 7 months, and 2 weeks after these dates, respectively. Patients completed QLQ-C30, QLQ-BR45, and Oslo COVID-19 QLQ-PW80 twice over four months. Patients ≥65 also completed QLQ-ELD14. The QOL of each group and changes in QOL for the whole sample were compared (non-parametric tests). Multivariate logistic regression identified patient characteristics related to (1) low global QOL and (2) changes in Global QOL between assessments. Results: Moderate limitations (>30 points) appeared in the first assessment in Global QOL, sexual scales, three QLQ-ELD14 scales, and 13 symptoms and emotional COVID-19 areas. Differences between the COVID-19 groups appeared in two QLQ-C30 areas and four QLQ-BR45 areas. Quality of Life improvements between assessments appeared in six QLQ-C30, four QLQ-BR45 and 18 COVID-19 questionnaire areas. The best multivariate model to explain global QOL combined emotional functioning, fatigue, endocrine treatment, gastrointestinal symptoms, and targeted therapy (R 2 = 0.393). The best model to explain changes in global QOL combined physical and emotional functioning, malaise, and sore eyes (R 2 = 0.575). Conclusions: Patients with breast cancer and COVID-19 adapted well to illness. The few differences between wave-based groups (differences in follow-up notwithstanding) may have arisen because the second and third waves saw fewer COVID restrictions, more positive COVID information, and more vaccinated patients.

How Did Breast Cancer Patients Fare during Different Phases of the COVID-19 Pandemic in Norway Compared to Age-Matched Controls?

“…In line with these findings in breast cancer patients, a study from the Netherlands [2] found minor differences in HRQoL measures during the early phase of the pandemic (compared to the pre-pandemic period). Another study from Spain [29] found that breast cancer patients seemed to adapt well to the COVID-19 pandemic. On the contrary, a single-center study from the USA showed that HRQoL in breast cancer patients was worsened by the COVID-pandemic (compared to the pre-pandemic period) [30].…”

“…The strengths of the study include the large sample size, the cancer-free control group, and data across three phases of the COVID-19 pandemic. This is in contrast to other studies of HRQoL in women with breast cancer during the pandemic which lacked a control group and post-pandemic comparison group [2,16,[28][29][30]. As mandated by law, reporting of cancer cases to the CRN ensures a complete dataset of all diagnosed breast cancer patients [36].…”