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Long-Term Adjustment and Quality of Life Among Breast Cancer Survivors Following Treatment

Tiffany Tibbs, M.A.
Teresa Deshields, Ph.D.
Laura Bayer, Ph.D.

Project Overview:

We are currently completing a project examining short-term, or acute, adjustment to survivorship among 95 breast cancer patients in the six months following the end of radiation treatment. This project has identified critical factors in adjustment and quality of life over time, and these trends have compelled us to consider longer-term evaluation of adjustment to survivorship. Preliminary data analyses suggest that significant changes in depression and quality of life occur as early as the first six weeks post-treatment. Older women (aged 55 and over) demonstrate higher quality of life and lower depression following treatment as compared to younger women. With regard to quality of life and depression, age is a more significant predictor of outcome than medical variables, including stage of cancer, number of comorbid illnesses, type of treatment, or number of treatments. It appears that older women make significant gains in quality of life over this short period of time. The proposed pilot study and subsequent investigations will help us to understand the course of recovery for older and younger cancer patients.

This pilot study will assess long-term survivorship among breast cancer patients at 18 months post-treatment. This study will provide us with data regarding women’s transition to long-term survivorship, which will be compared to results from our initial study of acute adjustment. We anticipate high rates of response, as the retention rate for our initial study of acute adjustment was excellent, with only three participants dropping out of the study despite the demands of five telephone interviews over six months.

The aims of this study are: (1) To document the psychological status of breast cancer survivors at 18 months after the conclusion of cancer treatment. (2) To compare the short-term and long-term psychological adjustment and quality of life among breast cancer survivors and to document the course of recovery. (3) To examine how age and medical status relate to adjustment and quality of life during the later phases of survivorship.

We propose to recruit participants from the cohort that completed the initial six month study of short-term adjustment following breast cancer treatment. They include 95 breast cancer patients (Stage 0-III) who underwent radiation treatment. Participants range in ages from 27 to 86. Approximately one quarter of the participants are African American.

We propose to conduct computer-assisted telephone interviews (CATI) to assess long-term psychological adjustment and quality of life in our cohort of breast cancer survivors at eighteen months post-treatment. We utilized this methodology in our initial study and found that it promotes retention of participants and reduces missing data; therefore, we plan to use this approach in studying long-term survivorship. In addition to the telephone interview, we plan to review medical chart information to document mortality and recurrence through the Medical Oncology database.

Descriptive statistics will be used to characterize the sample and will be compared to reports in the literature. For comparison with early adjustment, multivariate repeated measures ANOVAs with Bonferroni t-tests will be performed to compare scores on the outcome variables from end of treatment, six months post-treatment, and eighteen months post-treatment. Additional analyses to examine the relationship between age and medical status on adjustment and quality of life will be conducted. Multiple regression procedures will be used to determine predictors of long-term adjustment from initial psychosocial data.

Final Report:

The purpose of this project was to follow-up with survivors who participated in a study of short-term adjustment after treatment for breast cancer. In the initial project, we interviewed 95 women on 5 occasions over 6 months, beginning with the end of radiation therapy. The subsequent project added a 6th interview with the same women 18 months after the conclusion of treatment.

To read the full Final Report, please click here.