Possible socioeconomic and ethnic disparities in quality of life in a cohort of breast cancer survivors Quality of life of Danish women: Population-based norms for the EORTC QLQ-C30 Understanding quality of life in patients with colorectal cancer: comparison of data from a randomised controlled trial, a population based cohort study and the norm reference population Spinal stenosis, back pain, or no symptoms at all? A masked study comparing radiologic and electrodiagnostic diagnoses to the clinical impression. Base-line quality-of-life assessment in the National Surgical Adjuvant Breast and Bowel Project Breast Cancer Prevention Trial. Physical activity and breast cancer risk in a cohort of young women. The usefulness of a multidisciplinary educational programme after breast cancer surgery: a prospective and comparative study. The association between physical activity and health-related quality of life among breast cancer survivors Yoga for Patients with Early Breast Cancer and its Impact on Quality of Life - a Randomized Controlled Trial. Correlates of physical activity level in breast cancer survivors participating in the Women’s Healthy Eating and Living (WHEL) Study Lifetime physical activity and breast cancer risk in a multiethnic population: the San Francisco Bay area breast cancer study.
Background This paper describes the ethnic and socioeconomic correlates of functioning in a cohort of long-term nonrecurring breast cancer survivors . Methods Participants ( n = 804 ) in this study were women from the Health , Eating , Activity , and Lifestyle ( HEAL ) Study , a population -based , multicenter , multiethnic , prospect i ve study of women newly diagnosed with in situ or Stages I to IIIA breast cancer . Measurements occurred at three timepoints following diagnosis . Outcomes included st and ardized measures of functioning ( MOS SF-36 ) . Results Overall , these long-term survivors reported values on two physical function subscales of the SF-36 slightly lower than population norms . Black women reported statistically significantly lower physical functioning ( PF ) scores ( P = 0.01 ) , compared with White and Hispanic women , but higher mental health ( MH ) scores ( P < 0.01 ) compared with White and Hispanic women . In the final adjusted model , race was significantly related to PF , with Black participants and participants in the “ Other ” ethnic category reporting poorer functioning compared to the White referent group ( P < 0.01 , 0.05 ) . Not working outside the home , being retired or disabled and being unemployed ( on leave , looking for work ) were associated with poorer PF compared to currently working ( both P < 0.01 ) . Conclusion These data indicate that race/ethnicity influences psychosocial functioning in breast cancer survivors and can be used to identify need for targeted interventions to improve functioning The aim of this study was to derive population -based norms for women completing the EORTC QLQ-C30 version 1  which is design ed for use with patients who have cancer . The study was conducted using two different question naires : one design ed for use in female patients with breast cancer , the other for those with gynaecological cancers , but both including the EORTC QLQ-C30 . The women were drawn from the Danish Central Population Register without knowledge of their health status and divided at r and om between the two question naires . All procedures for collecting data were identical . The response rate for those receiving the gynaecological cancer ( GS ) question naire was 49 % and it was 71 % for the breast cancer ( BS ) question naire . Detailed comparison between the two sample s revealed several EORTC QLQ-C30 items showing a clear difference in distribution of scores between them . Because of this and the possible bias due to the relative low age-related response rate in GS , only the results from the BS are used for constructing norms . The norms cover all 30 single items on the EORTC QLQ-C30 and the nine derived scales , for women in four 10-year age groups commencing at 30 years and for those aged 70 - 75 . Clear trends in , for example , declining ability to undertake strenuous activity are illustrated and quantified . Levels of certain symptoms , such as pain , are surprisingly high although it is recognized that the population sample d will contain a proportion of women with active disease including cancer . We recommend the use of these norms both as an aid to the clinical assessment of an individual patient , and to assist in the interpretation of clinical trial and longitudinal quality of life data . As a secondary result , we note that a population -based sample will have a lower response rate to a question naire with more questions , especially if many of these extra questions are on sexual issues Abstract Background and aims : Quality of life ( QoL ) is an important outcome measure in clinical studies . However , there is little experience with the interpretation of QoL results . Methods : To guide interpretation of QoL results from a r and omised controlled trial ( RCT ) targeting the effectiveness of the immune modulator G-CSF on postoperative recovery in high risk ( ASA III/IV ) colorectal cancer patients , we compared RCT data with data from a population based cohort study and norm reference data . QoL was assessed using the European Organisation for the Research and Treatment of Cancer ( EORTC ) QLQ-C30 and CR38 question naires . QoL results were analysed on discharge from hospital and six months postoperatively . Results : Colorectal cancer patients ( both from the RCT and the cohort study ) showed the greatest differences in QoL scores compared to norm reference data at discharge from hospital . Six months postoperatively , global quality of life and pain approximated norm reference values indicating optimal recovery . However , deficits still appeared in scores for role functioning , physical functioning , social functioning and fatigue . The best improvements ( discharge from hospital to six months postoperatively ) were seen with respect to physical functioning , fatigue and pain . Conclusions : For further analysis of RCT data , physical functioning and fatigue scores may be more sensitive than global quality of life to detect differences in treatment effects OBJECTIVE To assess the relations between clinical ly recognized lumbar spinal stenosis and the conclusions of masked radiologists and electrodiagnosticians . DESIGN Prospect i ve , masked , double-controlled trial . SETTING University spine center . PARTICIPANTS One hundred fifty persons age 55 to 80 years with or without back pain and with or without magnetic resonance imaging (MRI)-demonstrated stenosis , screened for neuropathy risk , previous surgery , or cancer . INTERVENTIONS Question naires on pain and function ; ambulation testing and physical examination ; and masked electrodiagnotics and MRI . MAIN OUTCOME MEASURE Diagnostic impressions of the examining clinician , radiologist , and electrodiagnostician . RESULTS Following application of post hoc exclusion criteria and elimination of patients due to incomplete or inadequate test data , the clinical diagnosis was lumbar stenosis in 50 subjects , back pain in 44 subjects , and no pain in 32 subjects . Radiologic and clinical impression had no relation ( P = .80 vs asymptomatic , P = .99 vs back pain controls ) . Electrodiagnostic impression trended to relate to clinical impression ( P = .14 vs asymptomatic , P = .09 vs back pain ) . Retrospective application of age-related electrodiagnostic norms for paraspinal electromyographic and limb motor unit changes , established in this study , reclassified 13 of the 17 asymptomatic persons whom the electrodiagnostician thought had stenosis . The clinical impression did correspond to history and physical examination findings typically associated with spinal stenosis and to the independent impression of a neurosurgeon who examined MRI and clinical , but not to the electrodiagnostic data . CONCLUSIONS The impression obtained from an MRI scan does not determine whether lumbar stenosis is a cause of pain . Electrodiagnostic consultation may be useful , especially if age-related norms obtained in this study are applied BACKGROUND The Breast Cancer Prevention Trial ( BCPT ) is a large , multicenter chemoprevention trial testing the efficacy of the antiestrogen drug tamoxifen for prevention of breast cancer and coronary heart disease in healthy women at high risk of breast cancer . The BCPT evolved from a series of prior studies in early stage breast cancer demonstrating the efficacy of tamoxifen in the prevention of systemic breast cancer recurrence and in the reduction of contralateral breast cancers . PURPOSE The purpose of this article is to describe the method ologic considerations in the collection of health-related quality -of-life ( HRQL ) data in the BCPT and to present base-line HRQL data on the first 9749 participants . METHODS An HRQL question naire that included the Center for Epidemiologic Studies -Depression Scale , a symptom checklist , the Medical Outcomes Study 36-item short form ( MOS-SF-36 ) , and the MOS sexual problems questions was completed by participants in the BCPT at base line ( prior to r and om assignment ) . Medical and demographic information , as well as projected risk of breast cancer , were collected as part of study eligibility . Descriptive and correlational data were examined for these study participants . RESULTS BCPT participants report high levels of functioning compared with U.S. general population norms but still report an average of 8.9 distinct symptoms during the past 4 weeks . Depression is less prevalent among the participants than in community sample s , which reflects the exclusion of clinical ly depressed individuals . Sixty-five percent reported being sexually active in the past 6 months , with an age-related decline in sexual activity . Younger women reported fewer sexual problems than older women . There is a strong correlation between the two mental health measures , moderate to weak correlations between HRQL scales and levels of self-reported symptoms , and only weak correlations between measures of breast cancer risk and HRQL scales . The MOS-SF-36 scores were examined for three consecutive recruitment sample s ( 0 - 6 months , 7 - 12 months , and 13 - 20 months ) , and the base-line scores were slightly better for the earliest group of participants . CONCLUSIONS This article demonstrates the feasibility of collecting HRQL data in a large , multicenter , chemoprevention trial for women at high risk of breast cancer . The successful integration of HRQL data collection into this clinical trial attests to its value as a safety-monitoring end point and as an explicit and measurable outcome for the entire trial . IMPLICATION S HRQL data are important for studies in which healthy population s are involved and in which the potential for decrements in quality of life are real or perceived BACKGROUND Increased physical activity has been hypothesized to be a means of breast cancer prevention . We examined the associations between physical activity at two different times in life and breast cancer risk . METHODS We analyzed data from the Nurses ' Health Study II , a prospect i ve study of women aged 25 - 42 years in 1989 . On the baseline survey , women were asked , " While in high school and between the ages 18 and 22 years , how often did you participate in strenuous physical activity  at least twice a week ? " We averaged answers to these two questions to develop a measure of late adolescent activity . Women were also asked at baseline to report the number of hours per  week they currently spent in different nonoccupational activities . During 6 years of follow-up , we identified 372 cases of invasive breast cancer . Data were analyzed by use of multivariate pooled logistic regression to produce relative risk ( RR ) and confidence intervals ( CIs ) of being diagnosed with the disease . RESULTS Women who were more active in late adolescence were not at reduced risk of breast cancer compared with less active women . For those women who reported engaging in strenuous activity at least twice per week for 10 - 12 months per year in late adolescence , the RR of cancer , compared with those who never engaged in such activity , was 1.1 ( 95 % CI = 0.8 - 1.6 ) . Similarly , higher levels of recent nonoccupational physical activity were not associated with reduced risk of breast cancer ( RR for > or = 7 hours of activity/week relative to < 1 hour/week = 1.1 ; 95 % CI = 0.8 - 1.5 ) . CONCLUSION Our findings do not support a link between physical activity , in late adolescence or in the recent past , and breast cancer risk among young adult women The aim of the study was to compare and evaluate a multidisciplinary educational programme with traditional follow-up visits to a physician after breast cancer surgery in terms of well-being , aspects of self-care and coping ability 1 year after diagnosis . A reduction in the intensity of follow-up after breast cancer surgery is recommended . New follow-up models are being debated and could be of interest . The study design was non-r and omised and comparative . Ninety-six consecutively selected women with newly diagnosed breast cancer , classified as stage I or stage II , participated in either a multidisciplinary educational programme ( n=50 ) , or traditional follow-up by a physician ( n=46 ) . Three question naires were used : Functional Assessment of Cancer Therapy-General ( FACT-G ) , a study specific question naire regarding self-care aspects ( SCA ) and Sense of Coherence ( SOC ) . With the exception of physical well-being at baseline there was no significant difference between the groups . The women in the multidisciplinary educational programme increased their physical and functional well-being ( P<0.01 ) . The women in traditional follow-up by a physician increased their functional well-being while social/family well-being ( P<0.01 ) decreased over time . There was a statistically significant difference in SOC ( P<0.001 ) in the traditional follow-up by a physician between baseline ( mean=74.4 , SD=12.4 ) and the 1-year follow up ( mean=67.7 , SD=11.4 ) . Thus , women in the traditional follow-up by a physician scored lower in the area of SOC 1 year after diagnosis . A multidisciplinary educational programme may be an alternative to traditional follow-up by a physician after breast cancer surgery , but more research is needed about the financial benefits and effectiveness of such a programme Background The quality of life for breast cancer survivors has become increasingly important because of their high survival rate and prolonged life expectancy . The purpose of this study was to examine the association of physical activity following diagnosis and health-related quality of life ( HRQOL ) in breast cancer survivors . Methods We conducted a cross-sectional study of breast cancer survivors . A total of 231 women aged 21–78 years who had been diagnosed with stages I to III breast cancer and had breast cancer surgery at least 6 months prior were recruited from three hospitals between September 2012 and April 2015 and were included in this study . We asked participants about their HRQOL and engagement in physical activity using structured question naires . We examined the association between HRQOL levels and physical activity using a generalized linear model . Results Breast cancer survivors in the high physical activity group ( 3rd tertile ) were more likely to have lower scores for fatigue ( p for trend = 0.001 ) and pain ( p for trend = 0.02 ) and higher scores for sexual function ( p for trend = 0.007 ) than those in the low physical activity group ( 1st tertile ) . When we stratified participants by stage , we found increasing scores for physical functioning ( p for trend = 0.01 ) and decreasing scores for fatigue ( p for trend = 0.02 ) with increasing levels of physical activity in breast cancer survivors with stage I breast cancer . In survivors with stages II and III , we found statistically significant associations with fatigue ( p for trend = 0.02 ) and sexual functioning ( p for trend = 0.001 ) . Conclusions In conclusion , engagement in physical activity was related to better health-related quality of life among breast cancer survivors . Our findings may warrant further prospect i ve and intervention studies to support the benefit of physical activity in improving the quality of life and survival of Korean breast cancer survivors The aim of this prospect i ve , r and omized , controlled trial was to investigate the impact of yoga on newly diagnosed patients with early breast cancer in the immediate postoperative phase . 93 women newly diagnosed with early breast cancer were r and omized into an  intervention group ( IG ) and a control group ( waiting group , WG ) . The IG started yoga immediately after the operation . The WG started yoga 5 weeks after surgery . Both groups attended yoga classes twice weekly for 5 weeks . Quality of life ( QoL ) was evaluated using the EORTC QLQ-C30 and EORTC QLQ-BR23 question naires before the intervention , immediately after the operation and after 3 months . After 3 months the patients were asked whether yoga improved their physical activity and whether they wished to continue with yoga . The overall QoL ( p = 0.002 ) and the functional status ( p = 0.005 ) increased significantly in the IG , while physical symptoms decreased over time in both groups . 86 % of patients in the IG and only 59 % of patients in the WG ( p = 0.04 ) confirmed a positive change in their physical activity through yoga . More women in the IG intended to continue with yoga ( p = 0.03 ) . Early initiation of yoga as a supportive treatment in cancer had a positive impact on QoL. Teaching yoga allowed patients to practice yoga by themselves , enhanced the patients ' QoL and was found to improve physical activity Background  Physical activity levels among breast cancer survivors are typically low , and knowledge of the correlates of increased physical activity among cancer survivors is limited . The purpose of this study was to examine factors that are associated with physical activity or inactivity among breast cancer survivors . Methods Data from 3088 women participating in the Women ’s Healthy Eating and Living ( WHEL ) Study , collected prior to r and omization , were the focus of the current analyses . Self-reports of physical activity levels , quality of life , depression , and dietary intakes  were collected . Pearson correlation analyses were employed to examine the associations among these variables , and multiple regression analyses were performed to examine the relationship between selected health behaviors and physical activity levels , after controlling for demographic , breast cancer-related , and psychosocial variables . Results Demographic and psychosocial variables were related to physical activity levels ( P < 0.001 for all ) . Cancer treatment type and cancer stage were correlated with survivors ’ physical activity levels ( P < 0.01 ) , but the associations were no longer significant after controlling for demographic variables . Physical activity levels were strongly associated with other health behaviors , especially dietary intakes ( P < 0.001 ) , even after controlling for demographic , cancer-related , and psychosocial factors . Conclusion Low physical activity  levels in breast cancer survivors are associated with specific behavioral and other factors , which can be considered as indicators of women at higher risk . Findings of significant differences in  physical activity levels based on demographic characteristics suggest the importance of promoting physical activity particularly among breast cancer survivors of ethnic minority or lower education levels Considerable epidemiological data have accumulated in support of a lower risk of breast cancer among physically active women . Few studies , however , have examined the relation with lifetime physical activity from all sources , and moderate activity in particular . We conducted a population -based case-control study of breast cancer in Latinas , African Americans , and whites aged 35 - 79 years to assess the association with lifetime histories of moderate and vigorous physical activity , including recreational activity , walking , bicycling , household and outdoor chores , and occupation .  Patients diagnosed with invasive breast cancer between 1995 and 1998 were identified through the cancer registry in the San Francisco Bay area , and a r and om sample of women without breast cancer was identified through r and om-digit dialing . A structured question naire administered in-person was completed by 403 premenopausal cases and 483 controls and 847 postmenopausal cases and 1065 controls . Summing activities from all sources over an individual 's lifetime , we found reduced breast cancer risk in both pre- and postmenopausal women with the highest versus lowest tertile of average lifetime activity ( premenopausal : multivariate adjusted odds ratio = 0.74 , 95 % confidence interval = 0.52 - 1.05 ; postmenopausal : odds ratio = 0.81 , 95 % confidence interval = 0.64 - 1.02 ) , with similar reductions in the three racial/ethnic groups . In premenopausal women , risk reductions were similar for different types of activities , whereas in postmenopausal women , they were limited to occupational activity . Considering the intensity of activities , risk reductions were similar for moderate and vigorous activities . Because few of the currently known risk factors for breast cancer are modifiable , these results underline the public health importance of promoting physically active lifestyles
Aerobic fitness values were generally below average , although 6-minute walk time was closer to population norms .
Upper and lower extremity strength was lower than population norms for women who were currently receiving cancer treatment .
Lower extremity strength was above population norms for women who had completed treatment .
Aerobic capacity and upper extremity strength in women diagnosed with breast cancer are generally lower than population norms .
QUESTION What are typical values of physical function for women diagnosed with breast cancer and how do these compare to normative data ?