Clinical and sociodemographic determinants of disease-specific health-related quality of life in long-term breast cancer survivors

Daniela Doege*, Melissa S.Y. Thong, Lena Koch-Gallenkamp, Heike Bertram, Andrea Eberle, Bernd Holleczek, Alice Nennecke, Ron Pritzkuleit, Annika Waldmann, Sylke R. Zeissig, Hermann Brenner, Volker Arndt

*Corresponding author for this work


Purpose: It is important to monitor disease-specific health-related quality of life (HRQoL) in breast cancer (BC) survivors to identify potential unmet supportive care needs. However, previous studies were characterized by small samples of mostly short-term survivors and were limited to certain age ranges, stages and/or treatments. Methods: We used data from 3045 long-term BC survivors (5–15 years post-diagnosis) recruited in a German multi-regional population-based study. We assessed disease-specific HRQoL with the EORTC QLQ-BR23, scoring from 0 to 100. Differences in functioning and symptoms according to age at survey, self-reported treatments, stage, and disease status (disease-free vs. active disease) were assessed with multiple regression. Active disease was defined as any self-report of recurrence, metastasis or second primary cancer after the index cancer. Results: Older BC survivors reported a higher body image and a better future perspective, but lower sexual functioning. Survivors aged 30–49 years who had breast-conserving therapy or mastectomy with breast reconstruction reported a better body image compared to those who had mastectomy only. We also found differences in symptoms according to treatments in some age groups. Stage at diagnosis was not associated with HRQoL overall and in most age subgroups. Disease-free BC survivors aged 30–79 years reported a better future perspective and less systemic therapy side effects than those with active disease. Conclusion: Several treatment-associated symptoms and functioning detriments were found 5–15 years after diagnosis. The results emphasize the need of a comprehensive, individualized survivorship care, recognizing differential needs of long-term BC survivors according to age, treatment modalities, and disease status.

Original languageEnglish
JournalJournal of Cancer Research and Clinical Oncology
Issue number12
Pages (from-to)3461-3473
Number of pages13
Publication statusPublished - 12.2022

Research Areas and Centers

  • Research Area: Center for Population Medicine and Public Health (ZBV)


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