title: Quality of life determinants in women with breast cancer undergoing treatment with curative intent.
abstract: BACKGROUND
  The diagnosis of breast cancer and its subsequent treatment has significant impact on the woman's physical functioning, mental health and her well-being, and thereby causes substantial disruption to quality of life (QOL). Factors like patient education, spousal support and employment status, financial stability etc., have been found to influence QOL in the breast cancer patient. The present study attempts to identify the determinants of QOL in a cohort of Indian breast cancer patients.
  
  
  METHODS
  Functional Assessment of Cancer Therapy-Breast (FACT-B) Version 4 Malayalam was used to assess quality of life in 502 breast cancer patients undergoing treatment with curative intent. The data on social, demographic, disease, treatment, and follow-up were collected from case records. Data was analysed using Analysis of Variance (ANOVA) and multinomial logistic regression.
  
  
  RESULTS
  The mean age of the patients was 47.7 years with 44.6% of the women being pre-menopausal. The FACT-B mean score was 90.6 (Standard Deviation [SD] = 18.4). The mean scores of the subscales were - Physical well-being 19.6 (SD = 4.7), Social well-being 19.9 (SD = 5.3), Emotional well-being 14 (SD = 4.9), Functional well-being 13.0 (SD = 5.7), and the Breast subscale 23.8 (SD = 4.4). Younger women (< 45 years), women having unmarried children, nodal and/or metastatic disease, and those currently undergoing active treatment showed significantly poorer QOL scores in the univariate analysis. However multivariate analysis indicated that the religion, stage, pain, spouse education, nodal status, and distance travelled to reach the treatment centre as indicative of patient QOL.
  
  
  CONCLUSIONS
  QOL derangements are common in breast cancer patients necessitating the provisions for patient access to psychosocial services. However, because of the huge patient load, a screening process to identify those meriting intervention over the general population would be a viable solution.
authors.affiliation: Department of Surgical Oncology, Regional Cancer Centre, Trivandrum, India. manojpandey@vsnl.com
authors.forename: Manoj
authors.initials: M
authors.lastname: Pandey
authors.forename: Bejoy Cherian
authors.initials: BC
authors.lastname: Thomas
authors.forename: Padmakumar
authors.initials: P
authors.lastname: SreeRekha
authors.forename: Kunnambath
authors.initials: K
authors.lastname: Ramdas
authors.forename: Kuttan
authors.initials: K
authors.lastname: Ratheesan
authors.forename: Sankarannair
authors.initials: S
authors.lastname: Parameswaran
authors.forename: Beela S
authors.initials: BS
authors.lastname: Mathew
authors.forename: Balakrishnan
authors.initials: B
authors.lastname: Rajan