Psychological distress and health-related quality of life in women recently diagnosed with breast cancer in the Epi-GEICAM study.

Date 22 October 2018
Event ESMO 2018 Congress
Session Poster display session: Breast cancer - early stage, locally advanced & metastatic, CNS tumours, Developmental therapeutics, Genitourinary tumours - prostate & non-prostate, Palliative care, Psycho-oncology, Public health policy, Sarcoma, Supportive care
Topics Breast Cancer
Psychosocial Aspects of Cancer
Presenter Nerea , Fernández-De-Larrea
Citation Annals of Oncology (2018) 29 (suppl_8): viii58-viii86. 10.1093/annonc/mdy270
Authors N.,. Fernández-De-Larrea1, B. Pérez-Gómez2, A. Ruiz3, A.M. Casas4, B. Bermejo5, J.M. Baena-Cañada6, S. Antolin7, P. Sánchez Rovira8, M. Ramos Vázquez9, J.A. Garcia-Saénz10, A. Anton Torres11, M. Muñoz12, C. Jara13, M. Gil-Gil14, E. Adrover15, A. Oltra16, J. Brunet17, S. Bezares18, M. Martín19, M. Pollán20
  • 1Cancer Epidemiology Unit. Faculty Of Medicine., National Center for Epidemiology. Consortium for Biomedical Research in Epidemiology & Public Health (CIBERESP). University of Alcalá., 28029 - Madrid, Alcalá de Henares./ES
  • 2Cancer Epidemiology Unit., National Center for Epidemiology. Consortium for Biomedical Research in Epidemiology & Public Health (CIBERESP)., Madrid/ES
  • 3Medical Oncology Unit., Instituto Valenciano de Oncología. GEICAM., Valencia. Madrid./ES
  • 4Medical Oncology Unit., Hospital Virgen del Rocío. GEICAM., Sevilla. Madrid./ES
  • 5Medical Oncology Unit., Hospital Clinico de Valencia. GEICAM., Valencia. Madrid./ES
  • 6Medical Oncology Unit., Hospital Puerta del Mar. Instituto de Investigación en Biomedicina de Cádiz (INiBICA). GEICAM., Cadiz. Madrid./ES
  • 7Medical Oncology Unit., Complejo Hospitalario Universitario, A Coruña. GEICAM., A Coruña. Madrid/ES
  • 8Medical Oncology Unit., Complejo Hospitalario de Jaén. GEICAM., Jaén. Madrid./ES
  • 9Medical Oncology Unit, Centro Oncológico de Galicia. GEICAM., A Coruña. Madrid./ES
  • 10Medical Oncology Unit., Hospital Clínico Universitario San Carlos. GEICAM., Madrid./ES
  • 11Medical Oncology Unit., Hospital Miguel Servet. GEICAM., 50009 - Zaragoza/ES
  • 12Medical Oncology Unit. Translational Genomics And Targeted Therapeutics., Hospital Clinic I Provincial. Institut d’Investigacions Biomèdiques Pi i Sunyer-IDIBAPS. GEICAM., Barcelona. Madrid./ES
  • 13Medical Oncology, Hospital Universitario Fundación Alcorcón. /Universidad Rey Juan Carlos. GEICAM., Madrid/ES
  • 14Medical Oncology, Institut Català d'Oncologia Hospital Duran i Reynals. GEICAM., 08907 - Barcelona/ES
  • 15Medical Oncology Unit., Complejo Hospitalario Universitario de Albacete. GEICAM., Alicante. Madrid./ES
  • 16Medical Oncology Unit, Hospital Virgen de los Lirios. GEICAM, Alicante. Madrid./ES
  • 17Medical Oncology, Josep Trueta University Hospital, Catalan Institute of Oncology. GEICAM., 17007 - Girona/ES
  • 18Scientific Department, GEICAM, Madrid/ES
  • 19Medical Oncology, Instituto de Investigación Sanitaria Gregorio Marañón, CIBERONC, GEICAM, Universidad Complutense, 28029 - Madrid/ES
  • 20Cancer Epidemiology Unit., National Center for Epidemiology. Consortium for Biomedical Research in Epidemiology & Public Health (CIBERESP). GEICAM., Madrid/ES



Breast cancer (BC) diagnosis may have a high emotional impact in patients. Health-related quality of life (HRQL) can be impaired by the psychological impact of the diagnosis, by choices having to be made about treatment and by treatments themselves.


Cross-sectional analysis of HRQL in BC women from the Epi-GEICAM case-control study carried out in 23 Spanish hospitals. Women fulfilled a questionnaire about sociodemographic and lifestyle factors, HRQL (SF-36), mental health (GHQ-28) and social support (Duke-UNC). Spanish population norm-based scores were calculated for the SF-36 scales. Physical (PSS) and mental (MSS) summary scores ≥5 points under the norm were considered suboptimal. Psychological distress (PD) was defined as GHQ-28 >5. Factors associated with PD and suboptimal PSS were identified by multivariable mixed logistic regression models.


Among 1017 cases, 896 had complete SF-36 and GHQ-28. Median time since diagnosis was 77 days, 82% had been operated on, and 41% were on radiation/chemotherapy. Prevalence of PD was 54.4% (95% CI: 51.1-57.6). PD increased with TNM stage (p = 0.03). Other factors associated with PD were chemotherapy (OR = 1.7; 95% CI: 1.2-2.6), low social support (OR = 2.0; 95%CI: 1.2-3.5) and low education (OR = 2.1; 95% CI: 1.2-3.8). SF-36 scores are described in the table. Factors related to suboptimal PSS were surgery (OR = 3.2, 95% CI: 2.0-5.1), low education (OR = 1.9, 95% CI: 1.1-3.6) and number of comorbidities (OR = 1.3, 95% CI: 1.0-1.5). No differences in PD or PSS were observed according to BC subtype.


PD is very frequent during the initial stages of BC diagnosis and treatment. Advanced disease stage, lack of social support and low education are strong determinants of PD. The highest impact in HRQL was observed in the role-physical domain. PD and low PSS are interrelated and both are more frequent in patients with low education.Table: 268P

Mean*95% CI
Physical function41.240.342.1
Role physical36.836.037.5
Bodily pain45.044.445.7
General health46.946.247.5
Social function41.340.442.1
Role emotional44.643.845.5
Mental health46.746.147.4

<50: under the norm

Clinical trial identification

Legal entity responsible for the study

GEICAM Spanish Breast Cancer Group.


GEICAM Spanish Breast Cancer Group.

Editorial Acknowledgement


All authors have declared no conflicts of interest.