2893 - Factors Affecting Quality of Life in Breast Cancer Patients: An Analysis of a Prospective Clinical Trial Using FACT-B Questionnaire Scores
Presenter(s)
N. Tayeb1, J. F. Oyeniyi1, Y. C. Lee2, Y. Ramdas1, C. T. S. Liu3, and J. T. Dilworth1; 1Department of Radiation Oncology, Corewell Health William Beaumont University Hospital, Royal Oak, MI, 2Research Institute Corewell Health, Royal Oak, MI, 3Corewell Health East William Beaumont University Hospital, Royal Oak, MI
Purpose/Objective(s): Quality of life (QOL) is an important outcome in breast cancer care, yet factors influencing longitudinal QOL remain incompletely characterized. As a prespecified secondary objective on a prospective clinical trial, this study aimed to identify clinical, treatment-related, and psychosocial factors associated with QOL in breast cancer patients using the Functional Assessment of Cancer Therapy–Breast (FACT-B) questionnaire over time.
Materials/Methods: This analysis includes patients with locoregionally advanced breast cancer enrolled on a prospective clinical trial evaluating moderately hypofractionated whole breast/chest wall and regional nodal irradiation between 2018 and 2024. FACT-B questionnaires were prospectively administered per protocol at baseline and at 1–2 weeks, 3, 6, 12, 24, and 36 months. Sociodemographic, clinical, and treatment-related variables were collected. The primary outcome was a clinically meaningful QOL event, defined as a decline in FACT-B total score exceeding the minimal clinically important difference (=7 points). Fisher’s exact test was used for categorical comparisons, with odds ratios (ORs) and 95% confidence intervals (CIs) calculated for binary variables. Patients were cross-referenced for International Classification of Diseases, Tenth Revision (ICD-10) mental health disorder (MHD) codes (F01–F99) at baseline and within 3 years following diagnosis. Baseline National Comprehensive Cancer Network® (NCCN) Distress Thermometer scores were included.
Results: Fifty patients were analyzed, and 70% experienced at least one QOL event during follow-up. Overall chemotherapy exposure (any vs. none) was not significantly associated with QOL events (OR 2.03; 95% CI, 0.48–10.53; p = 0.35). Stratified analysis demonstrated a statistically significant difference between neoadjuvant and adjuvant chemotherapy groups (p = 0.047) and a trend toward significance between no chemotherapy and adjuvant chemotherapy (p = 0.096). Pre-existing anxiety disorders were more common among patients who experienced QOL events compared with those who did not (47% vs. 20%; p = 0.085). Post-diagnosis depressive disorders were more frequent among patients with QOL events (40% vs. 14%; p = 0.065), although temporal relationships could not be established. No significant association was observed between baseline distress scores and QOL events (p > 0.05).
Conclusion: In this exploratory analysis, receipt of adjuvant chemotherapy was associated with QOL decline. Trends also suggest that pre-existing anxiety disorders may be associated with clinically meaningful QOL deterioration during or within three years following radiation therapy. Further, patients experiencing QOL decline demonstrated higher rates of subsequent depressive disorders. These findings underscore the importance of further study and highlight opportunities for early supportive care interventions in select patients at higher risk for QOL decline.