QUALITY-OF-LIFE AND PREFERENCES FOR TREATMENT FOLLOWING SYSTEMIC ADJUVANT THERAPY FOR EARLY-STAGE BREAST-CANCER

Purpose: To evaluate the quality of life (QOL) of breast cancer patien ts who survived 2 to 5 years following initiation of adjuvant cytotoxi c and/or hormonal therapy and to characterize relationships between QO L and patient physical symptoms, sexual function, and preferences rega rding adjuvant treatment. Patients and Methods: Eighty-six patients wh o had completed systemic adjuvant therapy for early-stage breast cance r between 1988 and 1991 were surveyed by written questionnaire and tel ephone interview. Sociodemographic information was obtained for each p atient, and patients were asked to complete the Functional Living Inde x-Cancer (FLIC), the Symptom Distress Scale (SDS), the Medical Outcome s Study (MOS) Short Form 36 (SF-36), a series of questions regarding s exual function, and a survey about preferences for adjuvant therapy in relation to possible benefit. Results: The mean FLIC score among all patients was 138.3 (+/- 12.2), which suggests a high level of QOL. The reported frequency of moderate to severe symptoms was generally low ( ie, < 15%), with fatigue (31.4%), insomnia (23.3%), and local numbness at the site of surgery (22.1%) occurring with greatest frequency pati ents reported a wide range of sexual difficulties. Preference assessme nt showed that more than 65% of patients were willing to undergo 6 mon ths of chemotherapy for a 5% increase in likelihood of cancer cure. Co nclusion: Self-rated QOL in breast cancer patients 2 to 5 years follow ing adjuvant therapy was generally favorable. Less than one third of p atients reported moderate to severe symptoms. Selected aspects of sexu al function appeared to be compromised, The majority of patients indic ated a willingness to accept 6 months of chemotherapy for small to mod est potential benefit. (C) 1998 by American Society of Clinical Oncolo gy.