Avis Nancy E, Crawford Sybil, Manuel Janeen
Department of Public Health Sciences, Section on Social Sciences and Health Policy, Wake Forest University School of Medicine, Piedmont Plaza II, 2nd Floor, Winston-Salem, NC 27157-1063, USA.
J Clin Oncol. 2005 May 20;23(15):3322-30. doi: 10.1200/JCO.2005.05.130.
To describe quality of life (QOL) of younger women 4 to 42 months after breast cancer diagnosis and to identify factors associated with impaired QOL.
A total of 202 women diagnosed with stage I to III breast cancer at age 50 or younger from 4 to 42 months after breast cancer diagnosis previously completed a mailed survey. Global QOL; health-related QOL as measured by the Functional Assessment of Cancer Therapy-Breast Cancer (FACT-B); medical history; symptoms; days of work/activity missed after diagnosis; relationship, sexual, and body image problems; coping strategies; and feelings of preparedness were measured.
General aches and pains and unhappiness with appearance were reported by more than 70% of women. Hot flashes (P = .0007), pain with sexual intercourse (P = .02), and difficulty with bladder control (P = .002) all significantly increased with age. Global QOL was significantly lower than for a nonpatient sample of younger women (P < .0001). In general, few sociodemographic and medical factors were related to QOL. In multivariate analyses, days of work/usual activity missed immediately after diagnosis; relationship, sexual, or body image problems after diagnosis; and coping strategies were related to almost all QOL domains. Ongoing treatment, vaginal dryness, and feeling unprepared for the impact of breast cancer were related to some domains.
Younger breast cancer survivors are at risk for impaired QOL up to several years after diagnosis. Younger women, especially those at high risk for lower QOL, may need interventions that specifically target their needs related to menopausal symptoms and problems with relationships, sexual functioning, and body image. Preparing younger woman for the impact of breast cancer may also prove beneficial.
描述年轻女性在乳腺癌确诊后4至42个月的生活质量（QOL），并确定与生活质量受损相关的因素。
共有202名年龄在50岁及以下、在乳腺癌确诊后4至42个月被诊断为I至III期乳腺癌的女性，之前完成了一项邮寄调查。测量了总体生活质量；通过癌症治疗功能评估-乳腺癌（FACT-B）衡量的与健康相关的生活质量；病史；症状；确诊后错过的工作/活动天数；人际关系、性和身体形象问题；应对策略；以及准备情况。
超过70%的女性报告有全身疼痛和对外表不满意的情况。潮热（P = 0.0007）、性交疼痛（P = 0.02）和膀胱控制困难（P = 0.002）均随年龄显著增加。总体生活质量显著低于年轻女性非患者样本（P < 0.0001）。一般来说，很少有社会人口统计学和医学因素与生活质量相关。在多变量分析中，确诊后立即错过的工作/日常活动天数；确诊后的人际关系、性或身体形象问题；以及应对策略与几乎所有生活质量领域相关。持续治疗、阴道干燥以及对乳腺癌影响缺乏准备与某些领域相关。
年轻乳腺癌幸存者在确诊后长达数年都有生活质量受损的风险。年轻女性，尤其是生活质量较低风险较高的女性，可能需要针对其与更年期症状以及人际关系、性功能和身体形象问题相关需求的干预措施。让年轻女性为乳腺癌的影响做好准备也可能被证明是有益的。
