Patient-Reported Quality of Life 6 Years After Breast Cancer

This cohort study assesses quality-of-life trajectories up to 6 years after breast cancer diagnosis among individuals in France.


Introduction
Cancer contributes greatly to the global burden of chronic illness and has a tremendous impact patient's quality of life (QOL), including physical, emotional, and social domains. 1 The impact that cancer and its treatment have on an individual's health trajectory can vary substantially, meaning that some patients require more care resources than others. 2evious work 3 focused on a group of patients with early stage I to III breast cancer (BC) treated with adjuvant chemotherapy identified a cluster of patients with poor initial QOL and subsequent severe, persistent postchemotherapy QOL deterioration up to 4 years after diagnosis.
The current study aims to expand our previous work to unselected patients with BC to identify latent clusters of patients at risk for QOL deterioration up to 6 years after diagnosis and to assess the association of actionable host factors and health behaviors with QOL membership trajectory.

Methods
This cohort study followed the STROBE reporting guidelines.We performed a longitudinal analysis of QOL using a large, national, prospective cohort in

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Discussion
This cohort study identified factors associated with QOL deterioration, including actionable psychosocial and lifestyle-related factors.Limitations of this study include some attrition in responding to the questionnaires over time and the fact that changes in behavior across time were not dynamically assessed.Nevertheless, our results could be used to facilitate the creation of personalized, proactive, and preventive supportive care pathways 1,4 by targeting at-risk patients at diagnosis. 2 The efficacy of such pathways to prevent QOL deterioration, as well as the best implementation and care delivery model, should be investigated.
France (Chronic Toxicities Related to Treatment in Patients With Localized Cancer [CANTO]) 4 of patients with stage I to III BC treated from 2012 to 2018.This study was approved by French regulatory authorities and the French Committee for the Protection of Patients, and written informed consent was obtained from patients before participation. 4QOL (EORTC Quality of Life Questionnaire C30 summary score 3 ) was assessed at diagnosis (baseline) and 1, 2, 4, and 6 years after diagnoses.Baseline clinical, sociodemographic, behavioral, tumor-related, and treatment-related characteristics were available.Trajectories of QOL and group membership associations were identified by iterative estimations of group-based trajectory models and multivariable multinomial logistic regression, respectively.Data were analyzed May 5, 2023, using SAS statistical software version 9.4 (SAS Institute), including the PROC TRAJ package, and R statistical software version 4.0.3(R Project for Statistical Computing) with the MICE package.A 2-sided P < .05 was considered statistically significant.