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Quality of Life Among Younger Women With Breast Cancer

From the Wake Forest University School of Medicine, Department of Public Health Sciences, Winston-Salem, NC; University of Massachusetts Medical School, Division of Preventive and Behavioral Medicine, Worcester, MA

Address reprint requests to Nancy E. Avis, PhD, 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; e-mail: navis{at}wfubmc.edu

PURPOSE: 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.

METHODS: 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.

RESULTS: 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.

CONCLUSION: 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.

Supported by grant No. R01 CA64716 from the National Cancer Institute.

Presented at the American Psychosocial Oncology Society Meeting, Orlando, FL, January 29-February 1, 2004.

Authors' disclosures of potential conflicts of interest are found at the end of this article.

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