Abstract 2560
Background
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.
Methods
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.
Results
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.
Conclusions
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 function | 41.2 | 40.3 | 42.1 |
| Role physical | 36.8 | 36.0 | 37.5 |
| Bodily pain | 45.0 | 44.4 | 45.7 |
| General health | 46.9 | 46.2 | 47.5 |
| Vitality | 46.8 | 46.1 | 47.5 |
| Social function | 41.3 | 40.4 | 42.1 |
| Role emotional | 44.6 | 43.8 | 45.5 |
| Mental health | 46.7 | 46.1 | 47.4 |
<50: under the norm
Clinical trial identification
Legal entity responsible for the study
GEICAM Spanish Breast Cancer Group.
Funding
GEICAM Spanish Breast Cancer Group.
Editorial Acknowledgement
Disclosure
All authors have declared no conflicts of interest.
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