Quality of life changes during the pre- to postdiagnosis period and treatment-related recovery time in older women with breast cancer

BACKGROUND Health care providers have little population-based evidence about health-related quality of life (HRQOL) changes, from the pre- to postdiagnosis period, and treatment-related recovery time for women aged 65 years and older diagnosed with breast cancer. METHODS Older women with and without breast cancer completed self-reports of HRQOL at baseline and 2 years later as part of annual Medicare Health Outcomes Surveys (MHOS). MHOS was linked to Surveillance, Epidemiology, and End Results registries, which were used to categorize women with breast cancer by treatment type (breast-conserving surgery, breast-conserving surgery plus radiation, mastectomy) and time since diagnosis at follow-up. Each cancer case diagnosed in 1998 through 2007 (N = 542) was matched to 5 women without cancer (N = 2710) using propensity score matching. Analysis of covariance models examined changes in HRQOL, adjusting for demographics and initial functioning. RESULTS Older women within 6 months of diagnosis had greater declines than women without cancer in SF-36 Physical (−5.8 vs −1.8) and Mental (−3.6 vs −0.7) Component Summary scores, General Health (−12.3 vs −4.6), Vitality (−11.0 vs −2.2), Bodily Pain (−8.5 vs −2.1), Social Functioning (−15.1 vs −3.3), Role-Physical (−26.5 vs −3.9), and Role-Emotional (−13.1 vs −3.1) scores (all P