Tina Hsu and Pamela J. Goodwin, University of Toronto; Nicky Hood, Margaret Graham, and Pamela J. Goodwin, Samuel Lunenfeld Research Institute; Pamela J. Goodwin, Mount Sinai Hospital, Toronto; and Marguerite Ennis, Applied Statistician, Markham, Ontario, Canada.
J Clin Oncol. 2013 Oct 1;31(28):3540-8. doi: 10.1200/JCO.2012.48.1903. Epub 2013 Aug 26.
There is considerable interest in the quality of life (QOL) of long-term breast cancer (BC) survivors. We studied changes in QOL from time of BC diagnosis to long-term survivorship and compared QOL in long-term survivors to that of age-matched women with no history of BC.
In all, 535 women with localized BC (T1-3N0-1M0) were recruited from 1989 to 1996 and followed prospectively, completing QOL questionnaires at diagnosis and 1 year postdiagnosis. Between 2005 and 2007, those alive without distant recurrence were recontacted to participate in a long-term follow-up (LTFU) study. A control group was recruited from women presenting for screening mammograms, and both groups completed LTFU QOL questionnaires. Longitudinal change in BC survivors and differences between BC survivors and controls were assessed in eight broad categories with clinically significant differences set at 5% and 10% of the breadth of each QOL scale.
A total of 285 patients with BC were included in the study, on average 12.5 years postdiagnosis. Longitudinally, clinically significant improvements were observed in overall QOL by 1 year postdiagnosis with further improvements by LTFU. Some clinically significant improvements over time were seen in all categories. A total of 167 controls were recruited. Deficits were observed in self-reported cognitive functioning (5.3% difference) and financial impact (6.3% difference) in BC survivors at LTFU compared with controls.
Long-term BC survivors show improvement in many domains of QOL over time, and they appear to have similar QOL in most respects to age-matched noncancer controls, although small deficits in cognition and finances were identified.
长期乳腺癌（BC）幸存者的生活质量（QOL）受到广泛关注。我们研究了从 BC 诊断到长期生存期间 QOL 的变化，并将长期幸存者的 QOL 与无 BC 病史的年龄匹配女性进行了比较。
总共招募了 535 名局部 BC（T1-3N0-1M0）女性患者，这些患者于 1989 年至 1996 年被前瞻性招募，并在诊断时和诊断后 1 年完成 QOL 问卷。在 2005 年至 2007 年期间，那些无远处复发的患者被重新联系参加长期随访（LTFU）研究。对照组从参加筛查乳房 X 光检查的女性中招募，两组均完成 LTFU QOL 问卷。使用临床上有显著差异的 5%和 10%的 QOL 量表宽度，评估了 BC 幸存者的纵向变化和 BC 幸存者与对照组之间的差异。
共有 285 名 BC 患者纳入研究，平均在诊断后 12.5 年。纵向分析显示，诊断后 1 年时 QOL 整体有显著改善，LTFU 时进一步改善。所有类别中均观察到随时间的一些显著改善。共招募了 167 名对照组。与对照组相比，BC 幸存者在 LTFU 时报告认知功能（5.3%差异）和财务影响（6.3%差异）存在缺陷。
长期 BC 幸存者的 QOL 在多个领域随时间改善，而且在大多数方面与年龄匹配的非癌症对照组的 QOL 相似，尽管认知和财务方面存在一些小缺陷。
