Symptom experience and quality of life of women following breast cancer treatment

Background: Few studies have examined the correlates of breast cancer-related symptoms that persist posttreatment and determined the relationship between symptoms and quality of life (QOL). Methods: A population-based sample of women in the United States with stage 0-II breast cancer (n = 1372) completed a survey including the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire and the Breast Cancer-Specific Quality of Life Questionnaire. Described are the presence and frequency of 13 symptom scales and their associations with 10 QOL dimensions. Results: All study participants had completed primary treatment (surgery and radiation and/or chemotherapy, if applicable). Mean time from initial surgical treatment to completion of the questionnaire was 7.2 months (range 0.5-14.9 months). Mean number of symptoms reported was 6.8, with the 5 most common symptom scales being systemic therapy side effects (87.7%), fatigue (81.7%), breast symptoms (72.1%), sleep disturbance (57.1%), and arm symptoms (55.6%). Younger age and poorer health status at diagnosis were associated with worse symptoms. Fatigue had the greatest impact on QOL, with significant differences between those with high and low fatigue across 7 QOL dimensions. Sociodemographic, prior health status, clinical, and treatment/diagnostic factors explained only 9%-27% of the variance in QOL outcomes. Adding symptom experience increased the variance explained to 18%-60%. Conclusions: More attention to the reduction and management of disease and treatment-related symptoms could improve QOL among women with breast cancer.