Quality of life in long-term survivors of metastatic breast cancer.

Introduction: Psychosocial distress is common after a diagnosis of breast cancer. Little is known about the psychosocial adjustment of women living long term with metastatic breast cancer.

Methods: We conducted a cross-sectional survey of women living with metastatic breast cancer for 5 years or longer. The survey included demographic and medical history, the Hospital Anxiety and Depression Scale (HADS), the Revised Impact of Events Scale (IES-R), the Functional Assessment of Cancer Therapy-Breast (FACT-Breast), and the Duke-University of North Carolina (UNC) Functional Social Support (DUFSS) Questionnaire. Demographic and disease characteristics were assessed by using the Wilcoxon rank sum test and the Fisher exact test. The relationships between IES-R, DUFSS, and the HADS were assessed by using the Spearman correlation coefficients. Statistical tests were 2-sided, with significance defined as P ≤ .05.

Results: Eighteen (64%) of 28 eligible women completed the survey. Women who completed the survey were more likely to have had node-positive disease (2P = .0007), to had taken adjuvant therapy (2P = .01), and to have had hormone-receptor positive disease than women who did not (2P = .04). Among those who completed the survey, data from the FACT-Breast and the DUFSS indicated that women are physically functioning well but still face significant emotional challenges. Results from the HADS indicated that 2 (11.1%) of 18 women were depressed and that 2 (11.1%) of 18 women were anxious. Six (33%) of 18 women had scores on the IES-R Scale that indicated a powerful impact of traumatic stress on the ability to function. In the total sample of 18, the IES-R was significantly correlated with the HADS-Anxiety score (Spearman correlation, 0.81; 2P = .0002) but not with the HADS-Depression score (Spearman correlation, 0.40; 2P = .12).

Conclusions: Although overall quality of life is good in this population of women living long term with metastatic breast cancer, there is a subset of women who are dealing with significant anxiety and depression, and a larger group who are experiencing burdensome sadness, hopelessness, and apprehension about their disease. Ongoing work to address the needs of this population is warranted.