Unit for Late Effects after Cancer Treatment, Department of Oncology, Oslo University Hospital, Oslo, Norway.
Cancer Registry of Norway, Norwegian Institute of Public Health, Oslo, Norway.
J Patient Rep Outcomes. 2024 Sep 17;8(1):105. doi: 10.1186/s41687-024-00781-1.
PURPOSE: A breast cancer (BC) diagnosis may negatively affect health-related quality of life (HRQoL). However, there are few comparisons of HRQoL at several time points for women with BC, and particular when subdivided into invasive and in situ tumors. The purpose of this study was to investigate various aspects of HRQoL in women recently diagnosed with invasive BC or ductal carcinoma in situ (in situ) compared to age-matched BC free controls in a population-wide sample recruited through the Cancer Registry of Norway. METHODS: This cross-sectional study utilized HRQoL data collected in 2020-2022 from a digital survey including 4117 cases (3867 women with invasive BC and 430 with in situ) and 2911 controls. HRQoL was assessed ≥ 21 days after diagnosis, using EORTC QLQ-C30. This includes scores assessing global quality of life (gHRQoL) and HRQoL functions and symptoms. Multivariable regression analyses were used to compare HRQoL between cases and controls and to identify factors associated with gHRQoL and fatigue. Additionally, HRQoL 14 months after diagnosis was analyzed in 1989 of the included cases and in 1212 of the controls. Score differences of ≥ 10 points were considered clinically relevant and thus presented in the results. RESULTS: Invasive BC cases had lower gHRQoL, role- and social functioning in addition to more fatigue than controls. In situ cases had lower role-and social functioning than controls. Invasive BC cases scored worse than in situ on all domains, but the differences were not considered clinically relevant. Physical activity was associated with better gHRQoL and less fatigue in invasive BC, in situ and controls. Both invasive BC and in situ cases improved their role- and social functioning scores from diagnosis to 14 months follow-up, however no improvement was seen for fatigue. CONCLUSION: Women with invasive BC and in situ reported lower role- and social functioning scores than controls right after diagnosis with improvements 14 months after diagnosis. Physical activity was associated with better gHRQoL and less fatigue and should, whenever possible, play a key role in the care for BC patients.
目的：乳腺癌（BC）的诊断可能会对健康相关生活质量（HRQoL）产生负面影响。然而，很少有研究比较过患有 BC 的女性在多个时间点的 HRQoL，尤其是当分为浸润性和原位肿瘤时。本研究的目的是通过挪威癌症登记处招募的全人群样本，比较最近诊断为浸润性 BC 或导管原位癌（原位）的女性与年龄匹配的 BC 无癌对照者在多个方面的 HRQoL。
方法：本横断面研究利用 2020 年至 2022 年期间通过数字调查收集的 HRQoL 数据，包括 4117 例病例（3867 例浸润性 BC 女性和 430 例原位）和 2911 例对照。HRQoL 在诊断后至少 21 天用 EORTC QLQ-C30 进行评估。这包括评估总体生活质量（gHRQoL）和 HRQoL 功能和症状的评分。多变量回归分析用于比较病例和对照者的 HRQoL，并确定与 gHRQoL 和疲劳相关的因素。此外，对纳入的 1989 例病例和 1212 例对照者进行了诊断后 14 个月的 HRQoL 分析。评分差异≥10 分被认为具有临床意义，并在结果中呈现。
结果：与对照者相比，浸润性 BC 病例的 gHRQoL、角色功能和社会功能以及疲劳程度更低。原位病例的角色功能和社会功能比对照者差。与原位病例相比，浸润性 BC 病例在所有领域的评分都更差，但差异无临床意义。身体活动与浸润性 BC、原位和对照者的 gHRQoL 更好和疲劳程度更低相关。浸润性 BC 和原位病例从诊断到 14 个月随访时，角色功能和社会功能评分均有所改善，但疲劳程度没有改善。
结论：浸润性 BC 和原位病例在诊断后立即报告的角色功能和社会功能评分低于对照者，在诊断后 14 个月时有所改善。身体活动与更好的 gHRQoL 和更少的疲劳相关，在可能的情况下，应在 BC 患者的护理中发挥关键作用。
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