Bardwell WA et al. (2004) Health-related quality of life in women previously treated for early-stage breast cancer. Psycho-Oncology 13: 595–604

Health-related quality of life (HRQOL) is a good prognostic indicator in breast cancer but has only recently been included as an outcomes measure in clinical trials. To investigate HRQOL and its associated factors in women treated for early stage breast cancer within the previous 4 years, Bardwell et al. have analyzed a subset of data from the Women’s Healthy Eating and Living (WHEL) Study.

Women (n = 2582) completed the RAND-36 Health Survey, which includes four mental and four physical subscales measured from 0—100. Comparisons were made with US population norms and results from other breast cancer studies.

HRQOL was generally similar to population norms. Clinically meaningful differences were seen, however, in the ‘role limitations—due to physical problems’ subscale (6.7 points worse for the study population than for norms) and for ‘social functioning’ (5.2 points better for the study population than for norms). Comparisons with two other breast cancer studies again showed similar HRQOL, except for ‘role limitations—due to emotional problems’, in which the WHEL study participants were 5.1 points healthier. Multivariate analysis revealed that better physical HRQOL was linked to fewer psychological symptoms, lower body mass index, better sleep quality and more physical activity (P ≤ 0.001). Better mental HRQOL was related to better sleep quality, fewer life events, less pain and fewer gastrointestinal symptoms.

The study demonstrates that HRQOL was influenced by several factors. Bardwell et al. suggest that clinical interventions targeting some of these variables may improve HRQOL in these patients.