ASPO Abstracts
Health-Related Quality of Life Outcomes Among Breast Cancer Survivors
Category: Survivorship & Health Outcomes/Comparative Effectiveness Research
Conference Year: 2020
Abstract Body:
Purpose: Our study aims to (1) describe physical and mental health-related quality of life (HRQOL) in a large
sample of U.S. female breast cancer survivors, (2) identify associations between HRQOL and breast cancer
clinical characteristics, prognostic factors, and initial treatment characteristics, and (3) evaluate associations
between poor HRQOL after diagnosis and total mortality. Methods: Female breast cancer survivors (n= 2,401)
who were ≥1 year post-diagnosis and responded to a Survivorship Survey in 2012 were identified from the Sisters
Study. Physical and mental HRQOL were assessed using the 10-item PROMIS global short form. Scores were
transformed to T-score distributions with a mean of 50 and a standard deviation of 10. T-scores <40 were defined
as poor functioning. Multivariable logistic regression was used to assess predictors associated with poor HRQOL.
Cox regression was used to assess the association between HRQOL and mortality. Results: Overall, 5.0% of
breast cancer survivors reported both poor physical and mental HRQOL (6.2% reported poor physical HRQOL
alone and 5.9% reported poor mental HRQOL alone). Women with higher Charlson Comorbidity Index scores had
increased odds of poor physical HRQOL (1 vs. 0; Odds Ratio [OR]=2.66, 95% CI=1.95, 3.62 and ≥2 vs. 0;
OR=9.23; 95% CI=6.20, 13.74, respectively). Women who underwent breast reconstruction had a better physical
HRQOL compared to women who did not (OR=0.87; 95% CI=0.61, 1.24); however, the result was not statistically
significant. Dissatisfaction with reconstruction or experiencing surgery complications were associated with poor
physical HRQOL (OR=2.66; 95% CI=1.57, 4.51 and OR=1.93; 95% CI=1.41, 2.66). During follow-up (mean 3.9
years), 88 deaths were identified. Both poor physical and mental HRQOL were independent predictors of mortality
outcomes (HR=2.36; 95% CI=1.43, 3.90 and HR=1.92; 95% CI=1.16, 3.20) after adjusting for age at diagnosis,
time since diagnosis, prognostic factors, and comorbidity. Conclusions: Prognostic and cancer-treatment related
factors impact HRQOL in breast cancer survivors and may inform targeted survivorship care. PROMIS global
health measures may offer additional insights to patients’ well-being and mortality risk profiles.
Keywords: Health-Related Quality of life; Breast Cancer