Currently, over 1,700,000 women are living with breast cancer in the U
nited States. These long-term survivors of breast cancer are challenge
d to redirect their energy from issues of cancer treatment and early s
ide effects toward quality of life issues related to long-term survivo
rship, such as menopause, infertility, fear of recurrence, family dist
ress, and uncertainty. In an attempt to obtain patient perspectives on
quality of life and health care issues faced by breast cancer survivo
rs, focus group methodology was utilized in the first year of a 2 year
study. The sample was stratified to represent three age groups: <40 y
ears, 40-60 years, and >60, and was intended to represent different de
velopmental levels believed to have varying experiences with quality o
f life and potentially divergent needs following breast cancer diagnos
is. Results of these focus groups revealed unique quality of life conc
erns of breast cancer survivors across four domains of physical, psych
ological, social, and spiritual well being. Each of these domains yiel
ds important implications for future research and clinical practice. (
(C) 1997 by John Wiley & Sons, Ltd.).