Quality of life changes during the pre- to postdiagnosis period and treatment-related recovery time in older women with breast cancer
A partir de données d'enquête et des registres américains des cancers, cette étude analyse l'évolution de la qualité de vie, avant et après le diagnostic de cancer, et le temps de récupération après les traitements, chez des patientes atteintes d'un cancer du sein après 65 ans
Résumé en anglais
BACKGROUND Health care providers have little population-based evidence about health-related quality of life (HRQOL) changes, from the pre- to postdiagnosis period, and treatment-related recovery time for women aged 65 years and older diagnosed with breast cancer.
METHODS Older women with and without breast cancer completed self-reports of HRQOL at baseline and 2 years later as part of annual Medicare Health Outcomes Surveys (MHOS). MHOS was linked to Surveillance, Epidemiology, and End Results registries, which were used to categorize women with breast cancer by treatment type (breast-conserving surgery, breast-conserving surgery plus radiation, mastectomy) and time since diagnosis at follow-up. Each cancer case diagnosed in 1998 through 2007 (N = 542) was matched to 5 women without cancer (N = 2710) using propensity score matching. Analysis of covariance models examined changes in HRQOL, adjusting for demographics and initial functioning.
RESULTS Older women within 6 months of diagnosis had greater declines than women without cancer in SF-36 Physical (−5.8 vs −1.8) and Mental (−3.6 vs −0.7) Component Summary scores, General Health (−12.3 vs −4.6), Vitality (−11.0 vs −2.2), Bodily Pain (−8.5 vs −2.1), Social Functioning (−15.1 vs −3.3), Role-Physical (−26.5 vs −3.9), and Role-Emotional (−13.1 vs −3.1) scores (all P < .05). By approximately 1 year, women with and without breast cancer had similar HRQOL. Comparable declines in Physical Component Summary and Role-Physical occurred across treatment types.
CONCLUSIONS Women aged 65 years and older diagnosed with breast cancer should be counseled that survivors within 6 months of diagnosis are vulnerable to HRQOL declines, compared to women without breast cancer, but that decrements generally wane after 12 months. Cancer 2014. © 2014 American Cancer Society.
