title: Changes in health-related quality of life may predict recurrent breast cancer.
abstract: BACKGROUND
  Patient-reported outcomes incorporated in cancer clinical trials, are increasingly hypothesized to be predictors of disease-free survival. Previous research supports health-related quality of life (HRQoL) as an independent predictor of survival in patients with advanced or metastatic breast cancer. In contrast, recent studies provide evidence that baseline HRQoL scores are not associated with increased risk of relapse or survival in women with early-stage breast cancer. One plausible assumption might be that baseline HRQoL scores are limited as predictors of a recurrence of breast cancer several years after the initial diagnosis. In this explorative study, we examined whether changes in HRQoL over time may predict breast cancer recurrence. As a supplement, we investigated whether baseline HRQoL predicted recurrence.
  
  
  METHODS
  The study sample consisted of 141 participants in the International Breast Cancer Study Group adjuvant Trial 12-93 and Trial 14-93, from the Western region of Sweden. HRQoL was assessed, during a 5-year follow up. Poisson regression analysis was used to estimate the hazard function of recurrence depending on time since primary diagnosis and on HRQoL variables.
  
  
  RESULTS
  According to the Poisson multivariable regression analysis changes in physical well-being (beta=0.00439, p-value=0.0470), and nausea/vomiting (beta=-0.00612, p-value=0.0136) significantly predicted recurrence. Baseline HRQoL outcomes were not predictors of recurrence.
  
  
  CONCLUSIONS
  Changes of HRQoL during adjuvant therapy may be associated with recurrence. This explorative finding needs prospective investigation.
authors: Research and Development Centre, Skaraborg Hospital, Skövde, Sweden. elisabeth.kenne-sarenmalm@vgregion.se
authors: Elisabeth
authors: E
authors: Kenne Sarenmalm
authors: Anders
authors: A
authors: Odén
authors: Joakim
authors: J
authors: Ohlén
authors: Fannie
authors: F
authors: Gaston-Johansson
authors: Stig B
authors: SB
authors: Holmberg
mesh_terms: D000368:Aged; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology / Q000628:therapy; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006305:Health Status Indicators; D006801:Humans; D008875:Middle Aged; D015999:Multivariate Analysis; D009325:Nausea; D011237:Predictive Value of Tests; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic; D012008:Recurrence; D013548:Sweden / Q000453:epidemiology; D014839:Vomiting