Skip to main content
British Journal of Cancer logoLink to British Journal of Cancer
. 2000 Aug 16;83(5):577–582. doi: 10.1054/bjoc.2000.1337

Long-term quality of life in premenopausal women with node-negative localized breast cancer treated with or without adjuvant chemotherapy

F Joly 1,2, M Espié 3, M Marty 3, J-F Héron 2, M Henry-Amar 1
PMCID: PMC2363517  PMID: 10944595

Abstract

Our purpose was to evaluate the late physical and psychosocial difficulties of premenpausal patients treated for a localized breast cancer and to weigh the impact of chemotherapy on long-term quality of life. Two self-administered questionnaires, the EORTC core QLQ-C30 and the breast module (BR23) were mailed to 179 premenopausal node-negative women continuously disease-free, previously enrolled in a trial testing the efficacy of adjuvant CMF chemotherapy (Espié et al, 1997). The core questionnaire evaluates the physical, role, emotional, cognitive and social functioning and global health status. The breast module includes four functional scales: body image, sexual functioning, sexual enjoyment and future perspective. It also includes symptom scales such as arm or breast symptoms. Some specific professional and social states were added. 119 (68%) patients (mean age 54 years, range 30–69) participated. Mean follow-up time since diagnosis was 9.6 years (4–16). 68% had conservative and 32% radical surgery (with reconstructive surgery in 50%). CMF was given to 77 (65%) patients. Irradiation was administered in 75% of patients irrespective of adjuvant therapy. QLQ-C30 scale scores were similar in patients who had or had not received chemotherapy. Disturbance in body image, sex life and breast symptoms did not differ between patients who had or had not received adjuvant CMF. No major socioprofessional difficulties were reported except problems in borrowing from banks not related to past chemotherapy. With long follow-up, most premenopausal women treated for a localized breast cancer cope with the disease and its treatments. Adjuvant CMF chemotherapy does not appear to impair quality of life nor social and professional life in these patients. © 2000 Cancer Research Campaign

Keywords: localized breast cancer, clinical trial, premenopausal node-negative women, adjuvant chemotherapy, long-term quality of life

Full Text

The Full Text of this article is available as a PDF (76.7 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Aaronson N. K., Ahmedzai S., Bergman B., Bullinger M., Cull A., Duez N. J., Filiberti A., Flechtner H., Fleishman S. B., de Haes J. C. The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst. 1993 Mar 3;85(5):365–376. doi: 10.1093/jnci/85.5.365. [DOI] [PubMed] [Google Scholar]
  2. Barni S., Mondin R. Sexual dysfunction in treated breast cancer patients. Ann Oncol. 1997 Feb;8(2):149–153. doi: 10.1023/a:1008298615272. [DOI] [PubMed] [Google Scholar]
  3. Berglund G., Bolund C., Fornander T., Rutqvist L. E., Sjödén P. O. Late effects of adjuvant chemotherapy and postoperative radiotherapy on quality of life among breast cancer patients. Eur J Cancer. 1991;27(9):1075–1081. doi: 10.1016/0277-5379(91)90295-o. [DOI] [PubMed] [Google Scholar]
  4. Bernhard J., Hürny C., Coates A. S., Peterson H. F., Castiglione-Gertsch M., Gelber R. D., Goldhirsch A., Senn H. J., Rudenstam C. M. Quality of life assessment in patients receiving adjuvant therapy for breast cancer: the IBCSG approach. The International Breast Cancer Study Group. Ann Oncol. 1997 Sep;8(9):825–835. doi: 10.1023/a:1008269715091. [DOI] [PubMed] [Google Scholar]
  5. Craig T. J., Comstock G. W., Geiser P. B. The quality of survival in breast cancer: a case-control comparison. Cancer. 1974 May;33(5):1451–1457. doi: 10.1002/1097-0142(197405)33:5<1451::aid-cncr2820330531>3.0.co;2-g. [DOI] [PubMed] [Google Scholar]
  6. Dorval M., Maunsell E., Deschênes L., Brisson J., Mâsse B. Long-term quality of life after breast cancer: comparison of 8-year survivors with population controls. J Clin Oncol. 1998 Feb;16(2):487–494. doi: 10.1200/JCO.1998.16.2.487. [DOI] [PubMed] [Google Scholar]
  7. Dow K. H., Ferrell B. R., Leigh S., Ly J., Gulasekaram P. An evaluation of the quality of life among long-term survivors of breast cancer. Breast Cancer Res Treat. 1996;39(3):261–273. doi: 10.1007/BF01806154. [DOI] [PubMed] [Google Scholar]
  8. Ganz P. A., Coscarelli A., Fred C., Kahn B., Polinsky M. L., Petersen L. Breast cancer survivors: psychosocial concerns and quality of life. Breast Cancer Res Treat. 1996;38(2):183–199. doi: 10.1007/BF01806673. [DOI] [PubMed] [Google Scholar]
  9. Ganz P. A., Desmond K. A., Belin T. R., Meyerowitz B. E., Rowland J. H. Predictors of sexual health in women after a breast cancer diagnosis. J Clin Oncol. 1999 Aug;17(8):2371–2380. doi: 10.1200/JCO.1999.17.8.2371. [DOI] [PubMed] [Google Scholar]
  10. Ganz P. A., Rowland J. H., Desmond K., Meyerowitz B. E., Wyatt G. E. Life after breast cancer: understanding women's health-related quality of life and sexual functioning. J Clin Oncol. 1998 Feb;16(2):501–514. doi: 10.1200/JCO.1998.16.2.501. [DOI] [PubMed] [Google Scholar]
  11. Ganz P. A., Rowland J. H., Meyerowitz B. E., Desmond K. A. Impact of different adjuvant therapy strategies on quality of life in breast cancer survivors. Recent Results Cancer Res. 1998;152:396–411. doi: 10.1007/978-3-642-45769-2_38. [DOI] [PubMed] [Google Scholar]
  12. Goldhirsch A., Wood W. C., Senn H. J., Glick J. H., Gelber R. D. Fifth International Conference on Adjuvant Therapy of Breast Cancer, St Gallen, March 1995. International Consensus Panel on the Treatment of Primary Breast Cancer. Eur J Cancer. 1995 Oct;31A(11):1754–1759. doi: 10.1016/0959-8049(95)00479-3. [DOI] [PubMed] [Google Scholar]
  13. Halttunen A., Hietanen P., Jallinoja P., Lönnqvist J. Getting free of breast cancer. An eight-year perspective of the relapse-free patients. Acta Oncol. 1992;31(3):307–310. doi: 10.3109/02841869209108177. [DOI] [PubMed] [Google Scholar]
  14. Hietanen P. S. Measurement and practical aspects of quality of life in breast cancer. Acta Oncol. 1996;35(1):39–42. doi: 10.3109/02841869609098477. [DOI] [PubMed] [Google Scholar]
  15. Hughson A. V., Cooper A. F., McArdle C. S., Smith D. C. Psychological impact of adjuvant chemotherapy in the first two years after mastectomy. Br Med J (Clin Res Ed) 1986 Nov 15;293(6557):1268–1271. doi: 10.1136/bmj.293.6557.1268. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Hébert-Croteau N., Brisson J., Latreille J., Gariépy G., Blanchette C., Deschênes L. Time trends in systemic adjuvant treatment for node-negative breast cancer. J Clin Oncol. 1999 May;17(5):1458–1464. doi: 10.1200/JCO.1999.17.5.1458. [DOI] [PubMed] [Google Scholar]
  17. Hürny C., Bernhard J., Coates A. S., Castiglione-Gertsch M., Peterson H. F., Gelber R. D., Forbes J. F., Rudenstam C. M., Simoncini E., Crivellari D. Impact of adjuvant therapy on quality of life in women with node-positive operable breast cancer. International Breast Cancer Study Group. Lancet. 1996 May 11;347(9011):1279–1284. doi: 10.1016/s0140-6736(96)90936-8. [DOI] [PubMed] [Google Scholar]
  18. Joly F., Henry-Amar M., Arveux P., Reman O., Tanguy A., Peny A. M., Lebailly P., Macé-Lesec'h J., Vié B., Génot J. Y. Late psychosocial sequelae in Hodgkin's disease survivors: a French population-based case-control study. J Clin Oncol. 1996 Sep;14(9):2444–2453. doi: 10.1200/JCO.1996.14.9.2444. [DOI] [PubMed] [Google Scholar]
  19. Kiebert G. M., de Haes J. C., van de Velde C. J. The impact of breast-conserving treatment and mastectomy on the quality of life of early-stage breast cancer patients: a review. J Clin Oncol. 1991 Jun;9(6):1059–1070. doi: 10.1200/JCO.1991.9.6.1059. [DOI] [PubMed] [Google Scholar]
  20. Knobf M. T. Physical and psychologic distress associated with adjuvant chemotherapy in women with breast cancer. J Clin Oncol. 1986 May;4(5):678–684. doi: 10.1200/JCO.1986.4.5.678. [DOI] [PubMed] [Google Scholar]
  21. Lindley C., Vasa S., Sawyer W. T., Winer E. P. Quality of life and preferences for treatment following systemic adjuvant therapy for early-stage breast cancer. J Clin Oncol. 1998 Apr;16(4):1380–1387. doi: 10.1200/JCO.1998.16.4.1380. [DOI] [PubMed] [Google Scholar]
  22. Maguire G. P., Tait A., Brooke M., Thomas C., Howat J. M., Sellwood R. A., Bush H. Psychiatric morbidity and physical toxicity associated with adjuvant chemotherapy after mastectomy. Br Med J. 1980 Nov 1;281(6249):1179–1180. doi: 10.1136/bmj.281.6249.1179. [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. Maunsell E., Brisson J., Deschênes L. Arm problems and psychological distress after surgery for breast cancer. Can J Surg. 1993 Aug;36(4):315–320. [PubMed] [Google Scholar]
  24. Osoba D., Zee B., Pater J., Warr D., Kaizer L., Latreille J. Psychometric properties and responsiveness of the EORTC quality of Life Questionnaire (QLQ-C30) in patients with breast, ovarian and lung cancer. Qual Life Res. 1994 Oct;3(5):353–364. doi: 10.1007/BF00451727. [DOI] [PubMed] [Google Scholar]
  25. Palmer B. V., Walsh G. A., McKinna J. A., Greening W. P. Adjuvant chemotherapy for breast cancer: side effects and quality of life. Br Med J. 1980 Dec 13;281(6255):1594–1597. doi: 10.1136/bmj.281.6255.1594. [DOI] [PMC free article] [PubMed] [Google Scholar]
  26. Schover L. R., Yetman R. J., Tuason L. J., Meisler E., Esselstyn C. B., Hermann R. E., Grundfest-Broniatowski S., Dowden R. V. Partial mastectomy and breast reconstruction. A comparison of their effects on psychosocial adjustment, body image, and sexuality. Cancer. 1995 Jan 1;75(1):54–64. doi: 10.1002/1097-0142(19950101)75:1<54::aid-cncr2820750111>3.0.co;2-i. [DOI] [PubMed] [Google Scholar]
  27. Sprangers M. A., Groenvold M., Arraras J. I., Franklin J., te Velde A., Muller M., Franzini L., Williams A., de Haes H. C., Hopwood P. The European Organization for Research and Treatment of Cancer breast cancer-specific quality-of-life questionnaire module: first results from a three-country field study. J Clin Oncol. 1996 Oct;14(10):2756–2768. doi: 10.1200/JCO.1996.14.10.2756. [DOI] [PubMed] [Google Scholar]
  28. van Dam F. S., Schagen S. B., Muller M. J., Boogerd W., vd Wall E., Droogleever Fortuyn M. E., Rodenhuis S. Impairment of cognitive function in women receiving adjuvant treatment for high-risk breast cancer: high-dose versus standard-dose chemotherapy. J Natl Cancer Inst. 1998 Feb 4;90(3):210–218. doi: 10.1093/jnci/90.3.210. [DOI] [PubMed] [Google Scholar]

Articles from British Journal of Cancer are provided here courtesy of Cancer Research UK

RESOURCES