BACKGROUND The goal of this study was to compare health-related quality of life (HRQL) from diagnosis to 10 years postdiagnosis among breast cancer survivors (BCS) and women without cancer over the same period and to identify BCS subgroups exhibiting different HRQL trajectories. METHODS Our analysis included 141 BCS and 2086 controls from the Study of Women's Health Across the Nation (SWAN), a multiracial/ethnic cohort study of mid-life women assessed approximately annually from 1995 to 2015. Pink SWAN participants reported no cancer at SWAN enrollment and developed (cases) or did not develop (controls) incident breast cancer after enrollment. We assessed HRQL with SF-36 Mental Component Summary and Physical Component Summary scores. We modeled each as a function of case/control status, years since diagnosis, years since diagnosis squared, and the interaction terms between case/control status and the 2 time variables in linear models. We characterized heterogeneity in postdiagnosis HRQL of cases using group-based trajectories. RESULTS BCS had significantly lower HRQL compared with controls at diagnosis and 1 year postdiagnosis. By 2 years, BCS and controls no longer differed significantly. Among BCS, 2 trajectory groups were identified for both scores. For the Mental Component Summary, 88.4% of BCS had consistently good and 11.6% had very low scores. For the Physical Component Summary, 73.9% had good scores, and 26.1% had consistently low scores. Prediagnosis perceived stress and current smoking were related to being in the low mental trajectory group, and a higher number of comorbidities was related to being in the low physical trajectory group. CONCLUSION Although the majority of BCS have HRQL similar to non-cancer controls after 2 years, subgroups of BCS continue to have low HRQL. Prediagnosis stress, comorbidities, and smoking are vulnerability factors for long-term, low HRQL in BCS.

中文翻译：

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超过 10 年的乳腺癌幸存者和非癌症对照者的健康相关生活质量：粉红天鹅。

背景 本研究的目的是比较同期乳腺癌幸存者 (BCS) 和未患癌症的女性从诊断到诊断后 10 年的健康相关生活质量 (HRQL)，并确定表现出不同 HRQL 轨迹的 BCS 亚组。方法 我们的分析包括来自全国妇女健康研究 (SWAN) 的 141 名 BCS 和 2086 名对照，这是一项针对中年妇女的多种族/民族队列研究，从 1995 年到 2015 年大约每年评估一次。 Pink SWAN 参与者报告在 SWAN 登记时没有癌症并且在入组后发展（病例）或未发展（对照）偶发乳腺癌。我们使用 SF-36 心理成分总结和身体成分总结分数评估 HRQL。我们将每个模型作为病例/控制状态的函数，自诊断以来的年数，自诊断以来的年数平方，以及病例/控制状态与线性模型中的 2 个时间变量之间的交互项。我们使用基于组的轨迹来描述病例诊断后 HRQL 的异质性。结果 BCS 在诊断时和诊断后 1 年的 HRQL 显着低于对照组。到 2 年时，BCS 和对照不再有显着差异。在 BCS 中，为两个分数确定了 2 个轨迹组。对于心理成分总结，88.4% 的 BCS 一直保持良好，11.6% 的分数很低。对于物理组件总结，73.9% 的人得分很高，26.1% 的人得分一直很低。诊断前感知压力和当前吸烟与处于低心理轨迹组有关，较高数量的合并症与处于低生理轨迹组有关。结论 尽管 2 年后大多数 BCS 的 HRQL 与非癌症对照相似，但 BCS 亚组的 HRQL 仍然较低。诊断前压力、合并症和吸烟是 BCS 中长期、低 HRQL 的易感因素。