Younger women with breast cancer experience a decrease in health-related QOL

Younger women with breast cancer experience a decrease in their health-related quality of life (QOL), associated with increased psychological distress, weight gain, a decline in their physical activity, infertility and early onset menopause, according to a study published January 20 in the Journal of the National Cancer Institute.

Breast cancer is the most common non-skin cancer in women, and is the leading cause of death in women under 50 in the U.S. While the survival rate for younger women with breast cancer has improved over the last two decades, their cancer treatments, despite their effectiveness, can seriously affect QOL and other health outcomes.

To better understand the impact of cancer treatment on the quality of life of younger breast cancer survivors, Patricia A. Ganz, M.D., director of cancer prevention and control research at the Jonsson Comprehensive Cancer Center at the University of California Los Angeles, and colleagues did a review of studies that focused on overall QOL, psychosocial effects, menopause and fertility-related concerns, and behavioral outcomes related to weight gain and physical activity. The studies were published between January 1990 and July 2010. Of the 840 titles and abstracts reviewed, they focused on 28 with the most relevant data.

The researchers found that overall QOL was compromised in younger breast cancer survivors, with the mental issues more severe than the physical problems. Young women were also more depressed compared to the general age-matched population of women without cancer or women over 50 with breast cancer. Premature menopause, infertility and menopause-related symptoms were more common and contributing factors to the level of distress in women 50 or younger after treatment. Weight gain and physical inactivity were common health outcomes in younger women, although exercise rates generally increased after treatment.

The researchers write that in light of these adverse QOL outcomes, personalized treatment for breast cancer in younger women is particularly important. "By tailoring adjuvant therapy regimens and giving cytotoxic therapy only to those who may benefit, we can mitigate some of these side effects, but the long life expectancy for these younger women also provides a window of opportunity for cancer prevention and health promotion activities."