Aims

In recent years, major improvements in breast cancer treatments have led to a significant increase in survival. Despite that, this population's quality of life (QoL) information is lacking, especially real-world data.

Materials and methods

This was a prospective, multicentre, observational study of female breast cancer patients, without prior systemic treatment, treated between 2012 and 2019 in private health care in Brazil. QoL was assessed by two questionnaires, the EQ-5D-5L and the EORTC-QLQ-BR23. Additional data were retrospectively collected.

Results

The study comprised 1372 patients, most with early-stage disease (80.2% stages 0–II). At a median follow-up of 25.6 months, the estimated 3-year overall survival was 93.6%. Patients with locally advanced and metastatic breast cancer had the lowest visual analogue scale scores and the highest symptom burden in all dimensions of EQ-5D-5L, but with the most significant improvement after treatment. With the EORTC-QLQ-BR23 questionnaire, patients undergoing lumpectomy had a better perception of body image. Axillary dissection led to greater arm symptoms after 12 months, radiotherapy enhanced breast symptoms and patients treated with chemotherapy had significant worsening in the effects of systemic therapy compared with endocrine or HER2 therapy. Staging and immunohistochemical subtype correlated with survival and with several QoL parameters, but overall survival was not independently affected by patient-reported outcomes in this cohort.

Conclusion

Our results show that early diagnosis and access to treatments with fewer side-effects, such as endocrine or targeted therapy, and less aggressive surgeries are the best strategies to achieve a better QoL for breast cancer patients.

中文翻译：

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以患者为中心的乳腺癌结局：描述真实世界数据中的 EQ-5D-5L 和 EORTC-QLQ-BR23 测量值及其与生存的关联

目标

近年来，乳腺癌治疗的重大改进导致生存率显着提高。尽管如此，该人群的生活质量 (QoL) 信息仍然缺乏，尤其是真实世界的数据。

材料和方法

这是一项前瞻性、多中心、观察性研究，对 2012 年至 2019 年间在巴西私人医疗机构接受治疗的女性乳腺癌患者进行了前瞻性、多中心、观察性研究。生活质量通过两份问卷进行评估，EQ-5D-5L 和 EORTC-QLQ-BR23。回顾性收集了额外的数据。

结果

该研究包括 1372 名患者，大多数患有早期疾病（80.2% 为 0-II 期）。在中位随访 25.6 个月时，估计的 3 年总生存率为 93.6%。局部晚期和转移性乳腺癌患者在 EQ-5D-5L 的所有维度中视觉模拟量表评分最低，症状负担最高，但治疗后改善最显着。通过 EORTC-QLQ-BR23 问卷，接受乳房肿瘤切除术的患者对身体形象有更好的感知。12 个月后，腋窝解剖导致手臂症状加重，放疗增强了乳房症状，与内分泌或 HER2 治疗相比，接受化疗的患者全身治疗效果显着恶化。分期和免疫组化亚型与生存率和几个 QoL 参数相关，

结论

我们的研究结果表明，早期诊断和获得副作用较少的治疗，如内分泌或靶向治疗，以及不那么激进的手术是为乳腺癌患者实现更好生活质量的最佳策略。