OBJECTIVES: Provision of psychosocial support and rehabilitation for patients after cancer treatment is important for long-term health-related quality-of-life (HRQOL). Effective use of healthcare resources requires identification of patients requiring rehabilitation. The objectives of this study were to clarify the patterns of physical and psychosocial recovery over time and to identify the significant baseline and treatment-related factors predicting HRQOL at 6 months, 1 and 2 years after breast cancer surgery. METHOD(S): A multicenter longitudinal study was performed to evaluate physical conditions, anxiety, depression and HRQOL at one month, 6 months, and 1 and 2 years after surgery in 196 breast cancer patients. Physical conditions were evaluated using a patient-reported symptom checklist. HRQOL was rated using the Functional Assessment of Cancer Therapy scale-General (FACT-G) and the Breast Cancer subscale. Anxiety and depression were rated using the Hospital Anxiety and Depression Scale (HADS). RESULT(S): More than 50% of patients had local problems of "tightness", "arm weakness" and "arm lymphedema", and systemic problems of "reduced energy, fatigue, and general weakness" postoperatively. The HRQOL score significantly improved one year after surgery, and scores for physical, emotional and functional well-being also increased with time, whereas the score for social well-being was highest at baseline and decreased with time. Depression and anxiety significantly improved with time. Concomitant disease, marital status and the presence of a partner, anxiety and depression at baseline, pathological lymph node involvement, and adjuvant intravenous chemotherapy were significant factors predicting FACT-G scores at 6 months and 1 and 2 years after surgery. Depression at baseline was a strong predictor of HRQOL up to 2 years after surgery. CONCLUSION(S): These results suggest that physical rehabilitation is required for tightness and lymphedema, and a further study of psychosocial interventions is required to improve depression and social well-being.
Shimozuma, K., Taira, N., Shiroiwa, T., Ohsumi, S., Kuroi, K., & Saito, S. (2011). PSU23 Rehabilitation Needs and Predictive Factors of Health-Related Quality-of-Life in Breast Cancer Patients During Two Years After Surgery - A Multicenter Prospective Study. Value in Health, 14(7), A264. https://doi.org/10.1016/j.jval.2011.08.182