Quality of life during the COVID-19 pandemic and survival outcomes among breast cancer survivors.

BACKGROUND

Health-related quality of life (HRQoL) has long been recognized as a critical area of cancer research as it reflects patients' well-being, but less is known if HRQoL predicts survival outcomes in survivors of early stage breast cancer.

AIMS

We assessed racial disparities in HRQoL and the impact of HRQoL on survival outcomes in breast cancer survivors.

METHODS

This study included a total of 721 breast cancer survivors from the Chicago Multiethnic Epidemiologic Breast Cancer Cohort who completed the Functional Assessment of Cancer Therapy-Breast (FACT-B) instrument in 2020. We examined racial differences in FACT-B scores and patient characteristics correlated with FACT-B and its subscales using multiple linear regression. We used Cox regression to assess the associations between HRQoL assessments and survival outcomes.

RESULTS

Functional well-being score was lower in Black survivors than in White survivors (mean score: 19.6 vs. 20.9, P = 0.003). Being married was associated with a higher HRQoL score. Having a recurrence before interview and comorbidities worsened physical and emotional well-being. The total FACT-B score were significant predictors of both all-cause [hazard ratio (HR) = 0.68 per standard deviation, 95% CI 0.48-0.95] and breast cancer-specific mortality (HR = 0.57, 95% CI 0.37-0.88). Physical and functional well-being subscales were found to be associated with all-cause and breast cancer-specific mortality, and recurrence-free survival. Emotional well-being predicted breast cancer-specific mortality.

CONCLUSIONS

Our findings highlighted racial disparities in HRQoL and HRQoL associated with survival outcomes in breast cancer, suggesting the need to reduce the disparities and examine the long-term impact of HRQoL on health outcomes in future studies.