Impact of Therapy on Health-Related Quality of Life in Breast Cancer Patients >60 Years

Since the risk of developing breast cancer (BC) increases with age, it is primarily a challenge for the older population. Older patients are often affected by comorbidities and frailty. The aim of this study was to determine the impact of adjuvant therapy on quality of life in older BC patients, considering their global health status including comorbidities.

All BC patients aged 60 years old and above at initial diagnosis, who had been treated at the Breast Center of the LMU University Hospital of Munich, Germany, between 2010 and 2013, were eligible for participation. Quality of life was assessed by validated questionnaires. With a self-developed questionnaire, we assessed patients' general health status, oncological therapy as well as the Barthel Index and Charlson Comorbidity Index (CCI) as instruments of the geriatric assessment.

Data collected from 276 patients were included. Health-related quality of life (HRQoL) was affected by chemotherapy in the areas of physical function, mobility, fatigue, burden of disease, and financial difficulties. Regarding endocrine therapy, HRQoL was only affected in the area of burden of disease. A higher CCI and BMI as well as polymedication were significantly correlated with worse HRQoL.

This cross-sectional, retrospective analysis indicates that chemotherapy affects HRQoL negatively in several quality of life areas in the first 3 years after the initial diagnosis of BC. CCI, obesity, and polymedication also impact on HRQoL. This knowledge should be incorporated into the treatment decision-making process and targeted measures should be offered to support older patients.