Bloom Joan R, Stewart Susan L, Chang Subo, Banks Priscilla J
University of California, Berkeley 94720-7360, USA.
Psychooncology. 2004 Mar;13(3):147-60. doi: 10.1002/pon.794.
Women under age 50, a quarter of all cases of breast cancer, are especially vulnerable to physical and psychosocial late effects of their treatment due to having more aggressive treatment and their relative youth.
In person interviews were conducted with the population-based sample: 185 women who were under 50 at diagnosis and were cancer-free 5 years later. Quality of life in the physical, psychological, social, and spiritual domains was assessed and compared with results obtained a few months after diagnosis.
Five years after diagnosis, 92% rated their health as good or excellent, and only 10% said their health had been getting worse. Between baseline and 5 years, there were significant improvements in surgical symptoms, body image, worry about the future, patient-physician communication, intrusiveness of treatment, and all of the SF-36 measures except for general health. There were significant decreases in emotional support and the size of one's social network. More women were now menopausal (75% due to treatment) and there were fewer children at home. There were no significant changes in employment status, marital/partner status, sexual activity, sexual problems, self-esteem, and attendance at religious services or frequency of prayer. In multivariate models, a greater increase in physical quality of life was associated with reporting fewer chronic conditions, being employed, having been treated by chemotherapy and fewer had no children under age 18 living at home. A greater increase in mental quality of life was associated with fewer chronic conditions and a smaller decrease in emotional support.
Five years after diagnosis, young breast cancer survivors who remained cancer-free enjoyed good health and improved quality of life. Nonetheless, physical, social, and psychological concerns must be addressed so that young breast cancer survivors will continue to be resilient as they age.
50岁以下的女性占所有乳腺癌病例的四分之一，由于接受更积极的治疗以及她们相对年轻，她们特别容易受到治疗带来的身体和心理社会晚期影响。
对基于人群的样本进行了面对面访谈：185名诊断时年龄在50岁以下且5年后无癌症的女性。评估了身体、心理、社会和精神领域的生活质量，并与诊断后几个月获得的结果进行了比较。
诊断后五年，92%的人将自己的健康状况评为良好或优秀，只有10%的人表示自己的健康状况在恶化。从基线到5年，手术症状、身体形象、对未来的担忧、医患沟通、治疗的侵扰性以及除总体健康外的所有SF-36指标都有显著改善。情感支持和社交网络规模显著下降。现在更多的女性进入了更年期（75%是由于治疗），家里的孩子也更少了。就业状况、婚姻/伴侣状况、性活动、性问题、自尊以及参加宗教仪式或祈祷频率没有显著变化。在多变量模型中，身体生活质量的更大提高与报告的慢性病较少、就业、接受化疗治疗以及家里没有18岁以下的孩子有关。心理生活质量的更大提高与慢性病较少以及情感支持的下降较小有关。
诊断后五年，仍无癌症的年轻乳腺癌幸存者健康状况良好，生活质量有所改善。尽管如此，仍必须解决身体、社会和心理方面的问题，以便年轻的乳腺癌幸存者随着年龄的增长继续保持恢复力。
