ReviewQuality of life among long-term breast cancer survivors: A systematic review
Introduction
Breast cancer is the most prevalent malignancy among women in the industrialized world. One out of every nine women will ultimately be diagnosed with breast cancer in the USA before the age of 85 [1], while this figure is 1 in 11 in Europe. The prevalence of breast cancer rises markedly with age from 3–4% at age 50–69 to 6% of women older than 70 [2]. The number of long-term survivors, defined by the American Cancer Society as every person who is still alive 5 years after diagnosis [1], is increasing rapidly due to the growing rates of detection and incidence; the marked increase in the number and proportion of elderly; and improved survival 2, 3. This is in part also due to advances in cancer treatment. The relative survival of women with breast cancer at five years after initial diagnosis is now 86% [4]. All in all, this has led to increasing numbers of individuals who are either cured of their cancer or are living with it as a chronic disease [5].
The increasing numbers of long-term breast cancer survivors urge the examination of the long-term effects of breast cancer and specific treatments. The latter may need to be adapted in case of severe long-term side effects. In addition, specific medical and psychosocial needs of survivors should be assessed to be able to optimise aftercare. The goal of this review was to identify the specific aspects of quality of life that were affected in long-term breast cancer survivors, and to identify predictors. We reviewed the literature on well-being of breast cancer survivors in a systematic way.
Section snippets
Search strategy
A computerised search of the literature was performed in Pubmed and PsychINFO from 1960 to May 2004. The term ‘breast cancer’ was used in combination with other key terms: survivors, long-term, quality of life, QoL, health-related quality of life, HRQoL, well-being. The reference lists of all identified publications were checked to retrieve other relevant publications, which were not identified by means of the computerised search.
Selection criteria
Studies were included if they described aspects of the quality of
Study characteristics
In total, 10 studies were included, all published after 1996. All but two 7, 11 were conducted in the USA. The main findings are summarised in Table 3. Quality of life was a primary endpoint in all studies. Four studies compared the quality of life between breast cancer survivors and the general population 6, 7, 10, 11. Two studies examined the quality of life between breast cancer survivors diagnosed at different ages 8, 12. In addition, one study specifically examined the role of ethnicity [9]
Discussion
This systematic review summarises the results of 10 studies on the quality of life of long-term survivors of breast cancer (i.e. >5 years). Most studies reported that long-term survivors of breast cancer experienced good overall quality of life. In general, it can be concluded that survivors with a high quality of life are probably those who did not need chemotherapy; who have no comorbid diseases; who received sufficient emotional support from family and friends; and who had a relatively high
Conflict of interest statement
None declared.
References (22)
Long-term survival rates of cancer patients achieved by the end of the 20th century: a period analysis
Lancet
(2002)Why and how to study the fate of cancer survivors: observations from the clinic and the research laboratory
Eur J Cancer
(2003)- et al.
Prognostic factors of whiplash-associated disorders: a systematic review of prospective cohort studies
Pain
(2003) - et al.
The clinical course and prognostic factors of non-specific neck pain: a systematic review
Pain
(1998) - et al.
Systematic review of prognostic cohort studies on shoulder disorders
Pain
(2004) - et al.
Age-specific detriments to quality of life among breast cancer patients one year after diagnosis
Eur J Cancer
(2004) - Society AC. Cancer facts and figures-2000. Atlanta;...
- et al.
EUROCARE-3 summary: cancer survival in Europe at the end of the 20th century
Ann Oncol
(2003) - et al.
Relationship between quality of life and mood in long-term survivors of breast cancer treated with mastectomy
Support Care Cancer
(1997)
Long-term quality of life after breast cancer: comparison of 8-year survivors with population controls
J Clin Oncol
Cited by (459)
Exploration of the factors that influence perceived quality of patient centered care among cancer survivors: A systematic review
2024, European Journal of Oncology NursingValidation of the Spanish electronic version of the BREAST-Q questionnaire
2023, European Journal of Surgical OncologyQuality of life after emergency laparotomy: a systematic review
2024, BMC SurgeryCan illness representations be used to understand pain experienced in breast cancer survivorship—a cross-sectional study
2024, Journal of Cancer Survivorship