title: Health related quality of life in different states of breast cancer.
abstract: OBJECTIVE
  The aim of this study was to describe the health related quality of life (HRQoL) in different breast cancer disease states using preference-based measures.
  
  
  METHODS
  A total of 361 consecutive breast cancer patients attending the breast cancer outpatient clinic at Karolinska University hospital Solna for outpatient visits between April and May 2005 were included in the study. The EQ-5D self classifier and a direct Time Trade Off (TTO) question were used to estimate the HRQoL in different breast cancer disease states.
  
  
  RESULTS
  Patients in their first year after a primary breast cancer had a mean EQ-5D index value of 0.696 (95% confidence interval (CI): 0.634-0.747)). Patients in their first year after a recurrence had a mean EQ-5D index value of 0.779 (CI: 0.700-0.849). Patients who had not had a primary breast cancer diagnosis or a recurrence during the previous year had a mean EQ-5D index value of 0.779 (CI: 0.745-0.811). Patients with metastatic disease reported the lowest HRQoL values, and had a mean EQ-5D index value of 0.685 (CI: 0.620-0.735). The main driver behind the reduction in HRQoL was pain and discomfort as well as anxiety and depression. TTO values were higher for all diseases states compared to the EQ-5D index values.
  
  
  CONCLUSIONS
  This study shows that breast cancer is associated with a reduction in HRQoL. This effect is most pronounced for patients with metastatic disease.
authors.affiliation: Medical Management Centre, Karolinska Institutet, Stockholm, Sweden. mathias.lidgren@hhs.se
authors.forename: Mathias
authors.initials: M
authors.lastname: Lidgren
authors.forename: Nils
authors.initials: N
authors.lastname: Wilking
authors.forename: Bengt
authors.initials: B
authors.lastname: Jönsson
authors.forename: Clas
authors.initials: C
authors.lastname: Rehnberg
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000209:etiology; D001943:Breast Neoplasms / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology*; D003430:Cross-Sectional Studies; D003863:Depression / Q000209:etiology; D004522:Educational Status; D005260:Female; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D017063:Outcome Assessment, Health Care / Q000379:methods*; D010146:Pain / Q000209:etiology / Q000523:psychology*; D017060:Patient Satisfaction; D011788:Quality of Life; D019057:Quality-Adjusted Life Years; D018434:Sickness Impact Profile; D011795:Surveys and Questionnaires; D013548:Sweden; D013997:Time Factors