The Dynamics of Psychosocial Burden Development in Breast Cancer Survivors: Clinical Success with Psychosocial Consequences


Authors: V. Bencová 1;  V. Bella 1;  J. Švec 2
Authors‘ workplace: I. onkologická klinika Lekárskej fakulty UK a Onkologického ústavu sv. Alžbety, Bratislava, Slovenská republika 1;  Onkologická klinika, Slovenská zdravotnícka univerzita, Bratislava, Slovenská republika 2
Published in: Klin Onkol 2011; 24(3): 203-208
Category: Original Articles

Overview

Backgrounds:
Modified radical mastectomy (MRM) and breast-conserving surgery (lumpectomy, quadrantectomy – BCS) have shown equivalent clinical outcome in early stage breast cancer. On the other hand, quality of life and, probably, survival time of these patients are negatively influenced by fear of cancer recurrence, leading to episodes of anxiety, depression, and frustration, and, subsequently, physical, marital, sexual, and social functioning disorders. The aim of the present study was to analyze the dynamics and qualitative changes in psychosocial morbidity outcomes in breast cancer survivors one and three years after MRM versus BCS.

Methods:
A survey evaluating psychosocial morbidity of patients was performed by distributing Slovak version of the standardised EORTC-QLQ.C30:3 and EORTC-QLQ-BR23 questionnaires provided by the European Organisation for Research and Treatment of Cancer. The survey was performed in both arms of breast cancer patients surviving one and three years after MRM versus BCS.

Results:
Patients surviving one year post MRM or BCS scored their quality of life rather low (2–4, very bad – acceptable), while 78% patients surviving three years after BSC scored considerably higher (5–6, good – very good). However, 22% of patients in this arm considered their quality of life bad, scoring comparably with patients in the MRM arm. While psychosocial burden and behavioural risk profile remain fully expressed in MRM-treated breast cancer patients three years post surgery, the patients surviving three years after BCS suffer from significant emotional dysfunction.

Conclusion:
The shift in the quality and intensity of psychosocial dysfunction symptoms in breast cancer patients surviving three years after BCS requires greater attention related to the need for appropriate community-based psychosocial interventions and psychosocial prevention due to the negative impact of continuing and even accelerated psychosocial distress on the quality of life of surviving patients and remission period of the malignant disease.

Key words:
breast cancer – survival – psychosocial morbidity – quality of life – psychosocial intervention

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manuscript met the ICMJE “uniform requirements” for biomedical papers.


Sources

1. Aaronson NK, Ahmedzai S, Bergman B et al. 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; 85(5): 365–376.

2. Autier P, Ait Ouakrim D. Determinants of the number of mammography units in 31 countries with significant mammography screening. Br J Cancer 2008; 99(7): 1185–1190.

3. Autier P, Boniol M, La Vecchia C et al. Disparities in breast cancer mortality trends between 30 European countries: retrospective trend analysis of WHO mortality databases. BMJ 2010; 341: c3620.

4. Berrino F, De Angelis R, Sant M et al. Survival for eight major cancers and all cancers combined for European adults diagnosed in 1995–1999: results of the EUROCARE-4 study. Lancet Oncol 2007; 8(9): 773–783.

4. Burgess C, Cornelius V, Love S et al. Depression and anxiety in women with breast cancer: five years observation cohort study. BMJ 2005; 330(7493): 702–710.

5. Clark EJ. The importance of research in oncology social work. In: Lauria M, Clark EJ, Hermann J et al (eds). Social Work in Oncology. Atlanta, Ga: Am Cancer Society Press 2001.

6. Davis C. Psychosocial needs of women with breast cancer: how can social workers make a difference? Health Soc Work 2004; 29(4): 330–334.

7. Engel J, Kerr J, Schlesinger-Raab A et al. Quality of life following breast-conserving therapy or mastectomy: results of a 5 year prospective study. Breast J 2004; 10(3): 223–231.

8. Ganz PA, Desmond KA, Leedham B et al. Quality of life in long-term, disease-free survivors of breast cancer: a follow-up study. J Natl Cancer Inst 2002; 94(1): 39–49.

9. Ganz PA, Hahn EE. Implementing a survivorship care plan for patients with breast cancer. J Clin Oncol 2008; 26(5): 759–767.

10. Grassi L, Travado L. The role of psychosocial oncology in cancer care. In: Coleman MP, Alexe DM, Albrecht T et al (eds). Responding to the challenge of cancer in Europe. Ljubljana: Radovlica 2008.

11. Hewitt M, Greenfield S, Stovall E. From cancer patient to cancer survivor: lost in transition. Washington DC: The National Academies Press 2006.

12. Hodgkinson K, Butow P, Hunt GE et al. Breast cancer survivors’ supportive care needs 2–10 years after diagnosis. Support Care Cancer 2007; 15(5): 515–523.

13. Holzner B, Kemmler G, Kopp M et al. Quality of life in breast cancer patients – not enough attention for long-term survivors? Psychosomatics 2001; 42(2): 117–123.

14. IASWR Report to the National Cancer Institute. Social Worker’s contribution to research on cancer prevention, detection, diagnosis, treatment and survivorship. Nat Cancer Inst 2003: 44.

15. Kroenke CH, Kubzansky LD, Schernhammer ES et al. Social networks, social support, and survival after breast cancer diagnosis. J Clin Oncol 2005; 24(7): 1105–1111.

16. Kumle M. Declining breast cancer incidence and decreased HRT use. Lancet 2008; 372(9639: 608–610.

17. Levi F, Bosetti C, Lucchini F et al. Monitoring the decrease in breast cancer mortality in Europe. Eur J Cancer Prev 2005; 14(6): 497–502.

18. Lipscomb J, Donaldson MS, Hiatt RA. Cancer outcomes research and arenas of application. J Natl Cancer Inst Monogr 2004; 33: 1–7.

19. Michael YL, Berkman LF, Colditz GA et al. Social networks and health-related quality of life in breast cancer survivors: a prospective study. J Psychosom Res 2002; 52(5): 285–293.

20. Montazeri A. Health-related quality of life in breast cancer patients: a bibliographic review of the literature from 1974 to 2007. J Exp Clin Oncol 2008; 27: 32.

21. Nissen MJ, Swenson KK, Ritz LI et al. Quality of life after breast carcinoma surgery: a comparison of three surgical procedures. Cancer 2001; 91(7): 1238–1246.

22. Ohsumi S, Shimozuma K, Kuroi K et al. Quality of life of breast of breast cancer patients and types of surgery for breast cancer – current status and unresolved issues. Breast Cancer 2007; 14(1): 66–73.

23. Safaei-Diba Ch, Plesko I, Hlava P et al. Incidencia zhubných nádorov v Slovenskej republike 2006, Národný onkologický register SR: NCZI 2010.

24. Sprangers MA, Groenvold M, Arraras JI et al. 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; 14(10): 2756–2768.

Labels
Paediatric clinical oncology Surgery Clinical oncology
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