J Breast Cancer.  2011 Jun;14(2):112-118. 10.4048/jbc.2011.14.2.112.

Quality of Life Differences between Younger and Older Breast Cancer Patients

• Park BW
• Lee S
• Lee AR
• Lee KH
• Hwang SY

• KMID: 2286509
• DOI: http://doi.org/10.4048/jbc.2011.14.2.112

Abstract

PURPOSE
This study was designed to investigate quality of life (QOL) differences between younger (<50 years) and older (> or =50 years) breast cancer survivors and to determine the unique effect of age on QOL after adjusting age-correlated variables.
METHODS
One thousand two hundred fifty patients were enrolled. Clinicopatholgical and social parameters were reviewed and Functional Assessment of Cancer Therapy-Breast cancer instrument (FACT-B) and the Ladder of Life scale were used to measure the QOL. Among 1,250 eligible patients, 1,094 patients completed the questionnaire and were used for analysis. Chi-square test, t-test and a series of multiple regression analyses were conducted to verify age-related differences in QOL between two groups and to evaluate the unique contribution of age variable on QOL of breast cancer patients.
RESULTS
Significant socio-demographic and clinical differences existed based on age categories, including education, job, time since surgery, chemotherapy and daily activity. Also, there were significant age-related differences in FACT-B total, physical well-being, social/family well-being, functional well-being and breast cancer subscale and in subjective QOL. Older patients > or =50 years showed significantly lower QOL than younger patients <50 years. However, after controlling for age-correlated variables including job, education, time since surgery, chemotherapy, and daily activity, there was no unique age difference in QOL among breast cancer survivors.
CONCLUSION
Our study results suggest that older women with breast carcinoma suffered significantly lower QOL, even though the unique age effect was not found. Therefore, various interventions for enhancing QOL for women with breast carcinoma should be provided to older age group.

Keyword

Age-related differences; Breast carcinoma; Quality of life

MeSH Terms

Breast
Breast Neoplasms
Female
Humans
Quality of Life
Survivors
Surveys and Questionnaires

Reference

1. Ministry of Health, Welfare & Family Affairs. Annual Report of Cancer Incidence (2007), Cancer Prevalence (2007) and Survival (1993-2007) in Korea. 2009. Seoul: Ministry of Health, Welfare & Family Affairs.

2. Kwan ML, Ergas IJ, Somkin CP, Quesenberry CP Jr, Neugut AI, Hershman DL, et al. Quality of life among women recently diagnosed with invasive breast cancer: the Pathways Study. Breast Cancer Res Treat. 2010. 123:507–524.

3. Wenzel LB, Fairclough DL, Brady MJ, Cella D, Garrett KM, Kluhsman BC, et al. Age-related differences in the quality of life of breast carcinoma patients after treatment. Cancer. 1999. 86:1768–1774.

4. Ganz PA, Rowland JH, Desmond K, Meyerowitz BE, Wyatt GE. Life after breast cancer: understanding women's health-related quality of life and sexual functioning. J Clin Oncol. 1998. 16:501–514.

5. Mor V, Allen S, Malin M. The psychosocial impact of cancer on older versus younger patients and their families. Cancer. 1994. 74:7 Suppl. 2118–2127.

6. Avis NE, Crawford S, Manuel J. Quality of life among younger women with breast cancer. J Clin Oncol. 2005. 23:3322–3330.

7. Ganz PA, Lee JJ, Sim MS, Polinsky ML, Schag CA. Exploring the influence of multiple variables on the relationship of age to quality of life in women with breast cancer. J Clin Epidemiol. 1992. 45:473–485.

8. Parker PA, Baile WF, de Moor C, Cohen L. Psychosocial and demographic predictors of quality of life in a large sample of cancer patients. Psychooncology. 2003. 12:183–193.

9. Vinokur AD, Threatt BA, Vinokur-Kaplan D, Satariano WA. The process of recovery from breast cancer for younger and older patients. Changes during the first year. Cancer. 1990. 65:1242–1254.

10. Mor V. QOL measurement scales for cancer patients: differentiating effects of age from effects of illness. Oncology (Williston Park). 1992. 6:2 Suppl. 146–152.

11. Sammarco A. Quality of life of breast cancer survivors: a comparative study of age cohorts. Cancer Nurs. 2009. 32:347–356.

12. Maunsell E, Brisson J, Deschênes L. Psychological distress after initial treatment of breast cancer. Assessment of potential risk factors. Cancer. 1992. 70:120–125.

13. Goldberg JA, Scott RN, Davidson PM, Murray GD, Stallard S, George WD, et al. Psychological morbidity in the first year after breast surgery. Eur J Surg Oncol. 1992. 18:327–331.

14. Mosher CE, Danoff-Burg S. A review of age differences in psychological adjustment to breast cancer. J Psychosoc Oncol. 2005. 23:101–114.

15. Morabia A, Costanza MC. International variability in ages at menarche, first livebirth, and menopause. World Health Organization Collaborative Study of Neoplasia and Steroid Contraceptives. Am J Epidemiol. 1998. 148:1195–1205.

16. Bloom JR, Stewart SL, Johnston M, Banks P. Intrusiveness of illness and quality of life in young women with breast cancer. Psychooncology. 1998. 7:89–100.

17. Brady MJ, Cella DF, Mo F, Bonomi AE, Tulsky DS, Lloyd SR, et al. Reliability and validity of the Functional Assessment of Cancer Therapy-Breast quality-of-life instrument. J Clin Oncol. 1997. 15:974–986.

18. Yoo HJ, Ahn SH, Eremenco S, Kim H, Kim WK, Kim SB, et al. Korean translation and validation of the functional assessment of cancer therapy-breast (FACT-B) scale version 4. Qual Life Res. 2005. 14:1627–1632.

19. Schag CA, Heinrich RL, Aadland RL, Ganz PA. Assessing problems of cancer patients: psychometric properties of the cancer inventory of problem situations. Health Psychol. 1990. 9:83–102.

20. Hwang SY. Factors affecting quality of life among breast cancer survivors. Ment Health Soc Work. 2009. 33:257–287.

21. Ohsumi S, Shimozuma K, Morita S, Hara F, Takabatake D, Takashima S, et al. Factors associated with health-related quality-of-life in breast cancer survivors: influence of the type of surgery. Jpn J Clin Oncol. 2009. 39:491–496.

22. Leong SP, Shen ZZ, Liu TJ, Agarwal G, Tajima T, Paik NS, et al. Is breast cancer the same disease in Asian and Western countries? World J Surg. 2010. 34:2308–2324.

23. Ahn SH, Park BW, Noh DY, Nam SJ, Lee ES, Lee MK, et al. Health-related quality of life in disease-free survivors of breast cancer with the general population. Ann Oncol. 2007. 18:173–182.

24. Ashing-Giwa KT, Lim JW. Examining the impact of socioeconomic status and socioecologic stress on physical and mental health quality of life among breast cancer survivors. Oncol Nurs Forum. 2009. 36:79–88.

25. Shimozuma K, Ganz PA, Petersen L, Hirji K. Quality of life in the first year after breast cancer surgery: rehabilitation needs and patterns of recovery. Breast Cancer Res Treat. 1999. 56:45–57.

26. Yen JY, Ko CH, Yen CF, Yang MJ, Wu CY, Juan CH, et al. Quality of life, depression, and stress in breast cancer women outpatients receiving active therapy in Taiwan. Psychiatry Clin Neurosci. 2006. 60:147–153.

27. Osborne RH, Elsworth GR, Hopper JL. Age-specific norms and determinants of anxiety and depression in 731 women with breast cancer recruited through a population-based cancer registry. Eur J Cancer. 2003. 39:755–762.

28. Park BW, Hwang SY. Depression and coping in breast cancer patients. J Breast Cancer. 2009. 12:199–209.

29. Greimel ER, Padilla GV, Grant MM. Physical and psychosocial outcomes in cancer patients: a comparison of different age groups. Br J Cancer. 1997. 76:251–255.

30. Harrison J, Maguire P. Predictors of psychiatric morbidity in cancer patients. Br J Psychiatry. 1994. 165:593–598.