Young Women Don’t Have Poorer Quality of Life After Breast-Conserving Therapy
NEW YORK (Reuters Health) – Three years after radiotherapy, younger breast cancer survivors have health-related quality of life (HRQoL) no worse than similar women in the general population, researchers from The Netherlands report.
Some reports suggest that breast cancer has a more adverse impact on HRQoL in younger women than in older women, but other studies have not differentiated between the normal process of aging and the impact of age itself on HRQoL.
Dr. J. H. Maduro and colleagues from the University of Groningen in The Netherlands compared changes over time in various domains of HRQoL in 1420 younger and older women who had breast-conserving therapy, and in another 380 young women (50 years and younger) in the general population.
Their analyses included global health status, role functioning, emotional functioning, cognitive functioning, sexual functioning, fatigue, and pain.
By adjusting for other confounders, any changes over time reflected only the effects of age, the researchers said in a January 20 online report in the British Journal of Cancer.
None of the age groups showed significant or clinically relevant changes in global health status over time, and at three years of follow-up, the young breast cancer patients had comparable global health to the reference population.
Although the young breast cancer survivors showed significantly worse HRQoL immediately after completion of radiotherapy than the older breast cancer survivors for all functional outcomes except sexual functioning, the differences were small or of trivial clinical relevance, the authors say.
Over time, the younger group tended to have better functional outcomes than did the older group, but again these improvements were of small clinical relevance.
Sexual functioning differed significantly by age at all time points after radiotherapy, with younger women faring better than middle aged and older women.
Combined chemotherapy and endocrine therapy, and chemotherapy alone, were associated with worse cognitive functioning (compared with no systemic therapy), whereas additional radiotherapy to the nodal areas was negatively associated with sexual functioning.
Results were similar for the HRQoL symptom scales, with younger women reporting more fatigue and pain after radiotherapy (but of limited clinical relevance) that no longer differed from the reference population by three years after completion of radiotherapy.
“These results indicate that in the medium long-term, young age is not an independent risk factor for decreased HRQoL after radiotherapy in breast-conserved cancer patients,” the authors conclude.
Dr. Maduro did not respond to a request for comments.
Br J Cancer 2015.