The impact of age on changes in quality of life among breast cancer survivors treated with breast-conserving surgery and radiotherapy

Abstract

Background:The purpose of the study was to determine the impact of young age on health-related quality of life (HRQoL) by comparing HRQoL of younger and older breast cancer patients, corrected for confounding, and of young patients and a general Dutch population.Methods:The population consisted of breast cancer survivors (stage 0-III) after breast-conserving surgery and radiotherapy. Health-related quality of life was prospectively assessed using the EORTC QLQ-C30 and QLQ-BR23 questionnaires. The association between age (⩽50; 51–70; ⩾70 years) and HRQoL over time was analysed with mixed modelling. The clinical relevance of differences between/within age groups was estimated with Cohen's D and consensus-based guidelines. The HRQoL data from the young patient cohort were compared with Dutch reference data at 3 years after radiotherapy.Results:A total of 1420 patients completed 3200 questionnaires. Median follow-up was 34 (range 6–70) months. Median age was 59 (range 28–85) years. Compared with older subjects, young women reported worse HRQoL in the first year after radiotherapy, but clinical relevance was limited. Three years after radiotherapy, HRQoL values in the younger group were equal to those in the reference population. Pain and fatigue after radiotherapy improved, with medium clinical relevance.Conclusions:Three years after radiotherapy for breast cancer, young age was not a risk factor for decreased HRQoL.

Clinical Indicators of Psychosocial Distress Predict for Acute Radiation-Induced Fatigue in Patients Receiving Adjuvant Radiation Therapy for Breast Cancer: An Analysis of Patient-Reported Outcomes

“…The negative association of age with acute RT-induced fatigue is consistent with another prospective study that suggested significant worsening of a constellation of RTinduced symptoms during RT for younger patients (6). Other studies have demonstrated that younger patients are more likely to experience fatigue and other psychosocial issues, likely because of a greater fear of a cancer diagnosis (1,43,44). However, on multivariate analysis controlling for anxiety, sadness, and psychiatric/pain-related comorbidity, younger age remained a significant predictor in our analysis.…”

Assessment of age-related influences on the quality of life of breast cancer patients before and after surgical treatment

“…The age at diagnosis, therapeutic modality, as well as therapeutic sequelae all contribute to a breast cancer patient's QoL changes 11,15 . In this study we analyzed QoL of 170 early stage breast cancer female patients surgically treated, before and after treatment.…”

“…On the other hand, it has been observed that there was an improvement in the perceived QoL in all domains regardless of therapeutic modality. Bantema-Joppe et al 11 studied the influence of age on breast cancer patients' QoL after radiotherapy. The average follow-up time was 34 months (range 6-70 months), and results were compared to age-matched controls in the general population in Holland.…”

“…The normal aging process carries with it QoL changes. Data suggests that younger breast cancer patients experience greater QoL changes than their older counterparts 11 . Agerelated differences in the psychological reactions to breast cancer and its therapy can be observed between younger breast cancer patients (under 50 years of age) and their older counterparts (50 years of age or older).…”

General Overview and Treatment Recommendations for Young Women with Breast Cancer

“…A prospective cohort study from the Netherlands demonstrated that healthrelated quality of life (which includes the role functioning, emotional and cognitive functioning, fatigue, and pain) in the first year after BCS and radiotherapy is more strongly affected in young breast cancer survivors than in older patients, but improves over time 144 .…”