A population-based study of the impact of specific symptoms on quality of life in women with breast cancer 1 year after diagnosis

BACKGROUND. Whereas the role of specific symptoms, such as pain and fatigue, for quality of life (QOL) is unquestioned, their relative importance for long-lasting impairments in QOL in cancer patients has rarely been assessed quantitatively. The authors, therefore, aimed to identify symptoms most predictive of limitations to function and overall QOL in women with breast cancer after completion of primary therapy. METHODS. The European Organisation for Research and Treatment of Cancer questionnaire QLQ-C30 and the breast-cancer-specific module QLQ-BR23 were used to measure QOL in a population-based sample from Saarland (Germany) of 314 women with breast cancer 1 year after diagnosis. Symptoms most predictive for limitations to function and overall QOL were identified with a multiple linear regression analysis. RESULTS. Fatigue emerged as the strongest predictor by far of QOL, explaining around 30% to 50% of variability within function scores and overall QOL. Other symptoms, including pain, nausea and/or vomiting, breast symptoms, systemic therapy side effects, and arm symptoms, explained on average < 5% of variability of various QOL scales beyond fatigue and age. Sociodemographic and clinical factors had little impact on QOL. CONCLUSIONS. Although QOL is a multidimensional concept, the analysis suggested that fatigue is the symptom that had, by far, the largest impact on limiting function and on overall QOL in breast cancer patients after their completion of primary therapy. Specific interventions to reduce the burden of fatigue may represent a particularly worthwhile effort to improve QOL in women with breast cancer.