Quality of Life in Slovak Breast Cancer Survivors: A Cross-Sectional Study Using EORTC QLQ-C30 and BR23

Objectives: This study sought to assess quality of life (QoL) in Slovak breast cancer survivors and examine its association with treatment modalities and sociodemographic factors. Methods: This cross-sectional observational study included 244 Slovak female breast cancer survivors (stages IA-IIIC). Participants were aged 25-85 years, ECOG 1-2, without synchronous malignancies or severe comorbidities. Data were collected using the EORTC QLQ-C30 and breast cancer-specific module. Results: Mean global health status/QoL indicated a moderate QoL level (51.67). Emotional and cognitive functioning were relatively preserved, whereas social and role functioning were more impaired. The most prominent symptoms included insomnia, fatigue, dyspnoea, and pain. Breast cancer-specific domains showed relatively high body image scores but marked impairment in sexual activity and future perspective. Severe symptoms included hair loss, upper limb problems and systemic side effects of therapy. Significant differences were observed across functional domains and symptoms (p < 0.001). Chemotherapy was associated with better role functioning (p = 0.011), lower pain (p = 0.043) and insomnia (p = 0.012), but also with higher levels of hair loss (p = 0.003); however, these findings should be interpreted with caution due to potential confounding factors. Radiotherapy was associated with higher social functioning, body image and future perspective (p = 0.007 for all), but also with increased breast symptom severity (p = 0.044). Sociodemographic factors, particularly place of residence and education level, were significantly associated with overall QoL. Conclusions: Slovak breast cancer survivors report moderate overall QoL, with emotional and cognitive functioning relatively preserved, but social, role and sexual domains impaired. Treatment modalities and sociodemographic factors are associated with differences in specific QoL domains, highlighting the need for targeted, context-sensitive supportive care. The findings also underscore the importance of oncology nursing in survivorship care, particularly in addressing physical, social and sexual domains and key symptoms such as insomnia, fatigue and pain. Targeted psychosocial and educational support, along with culturally sensitive QoL assessment, may help improve patient-centred outcomes in breast cancer survivors in Central and Eastern Europe.