Development of a holistic strategy for the assessment of the quality of life in patients with breast cancer in the different stages of the disease

Abstract

Introduction: Breast cancer is considered a chronic disease that has considerable impact on the quality of life (QoL) of the patients. Yet, there is not a totally satisfactory evaluation system reflecting the complexity of the breast cancer condition. Furthermore, most instruments are more addressed towards early-stage disease than advanced disease. Objective: To describe the methodology used to measure the QoL of life and coping strategies in a representative group of breast cancer patients including metastatic and non-metastatic patients. Methodology: Prospective study including patients with breast cancer at different stages of the disease recruited at the Medical Oncology Department of the Catalan Oncology Institute (ICO) previous informed consent. A protocol of approximately one hour face-to-face interview is run to collect sociodemographic information and to answer the questions of several QoL scales such as the QLCA-AFex Font, QLQ-C30, QLQ-BR23, HADS, DME, BRCS, MINI-MAC, LOT-R and OE questionnaires, complemented by a semi-structured interview. Results: From June 2017 to March 2020, 257 patients were included in the study. Mean age 57.9 years (SD 10.1), mostly women (98.8%), with children (87.9%) and married (65.4%). According to clinical status 75.5% were non-metastatic and 24.5% metastatic. Protocol compliance was achieved in more than 90% in all questionnaires without differences between metastatic and no metastatic patients. Conclusions: This multidimensional protocol enables us to make an integral assessment of the QoL of the patients and their unmet needs, as well as to reflect the patients’ concerns, both in early and advanced stages of the disease, complementing currently available assessment methods. In the next future a complied questionnaire with the most challenging questions could be developed to be useful as a routine instrument in clinical practice.