Umutoni Victoria, Sun Yijia, Freeman Jincong Q, Zhao Fangyuan, Olopade Olufunmilayo I, Huo Dezheng
Department of Public Health Sciences, University of Chicago, Chicago, IL, USA.
Center for Health and the Social Sciences, University of Chicago, Chicago, IL, USA.
Breast Cancer Res Treat. 2025 Aug 15. doi: 10.1007/s10549-025-07808-1.
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.
We assessed racial disparities in HRQoL and the impact of HRQoL on survival outcomes in breast cancer survivors.
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.
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.
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.
长期以来，健康相关生活质量（HRQoL）一直被认为是癌症研究的一个关键领域，因为它反映了患者的幸福感，但对于HRQoL是否能预测早期乳腺癌幸存者的生存结果，人们了解较少。
我们评估了乳腺癌幸存者在HRQoL方面的种族差异以及HRQoL对生存结果的影响。
本研究共纳入了来自芝加哥多民族乳腺癌队列的721名乳腺癌幸存者，他们于2020年完成了癌症治疗功能评估-乳腺癌（FACT-B）量表。我们使用多元线性回归分析了FACT-B得分的种族差异以及与FACT-B及其子量表相关的患者特征。我们使用Cox回归评估HRQoL评估与生存结果之间的关联。
黑人幸存者的功能幸福感得分低于白人幸存者（平均得分：19.6对20.9，P = 0.003）。已婚与较高的HRQoL得分相关。在访谈前有复发和合并症会使身体和情绪幸福感恶化。FACT-B总分是全因死亡[风险比（HR）=每标准差0.68，95%置信区间0.48-0.95]和乳腺癌特异性死亡（HR = 0.57，95%置信区间0.37-0.88）的显著预测因素。身体和功能幸福感子量表与全因和乳腺癌特异性死亡以及无复发生存相关。情绪幸福感可预测乳腺癌特异性死亡。
我们的研究结果突出了乳腺癌幸存者在HRQoL方面的种族差异以及HRQoL与生存结果的关联，表明在未来研究中需要减少这些差异并研究HRQoL对健康结果的长期影响。
