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. Reference data for the quality of life questionnaire EORTC QLQ-C30 in the general German population. Change in physical activity during active treatment in a prospective study of breast cancer survivors Physical and psychosocial recovery in the year after primary treatment of breast cancer. Physical Activity and Survival after Diagnosis of Invasive Breast Cancer Neuropsychological function in high-risk breast cancer survivors after stem-cell supported high-dose therapy versus standard-dose chemotherapy: evaluation of long-term treatment effects. The effect of physical activity on breast cancer risk: A cohort study of 30,548 women Dietary carbohydrates and breast cancer risk: a prospective study of the roles of overall glycemic index and glycemic load. Quality of life among younger women with breast cancer: study from a tertiary cancer institute in south India. Massage therapy reduces physical discomfort and improves mood disturbances in women with breast cancer. Twenty five year follow-up for breast cancer incidence and mortality of the Canadian National Breast Screening Study: randomised screening trial Quality of life among women recently diagnosed with invasive breast cancer: the Pathways Study Quality of life, problems, and needs of disease-free breast cancer survivors 5 years after diagnosis
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 The objective of this study was to obtain age- and sex-specific reference values for the European Organization for Research and Treatment of Cancer ( EORTC ) Quality of Life Question naire QLQ-C30 . A r and omly selected sample of the German adult population ( 3015 subjects ) was used , 2081 subjects agreed to take part in the investigation . Most of the scales and symptom items of the question naire proved to be dependent on age and sex . Men reported fewer symptoms than women . Age differences were even more pronounced . Younger people reported better functioning and fewer symptoms . Compared with the results of a similar Norwegian study ( Hjermstad MJ , Fayers PM , Bjordal K , Kaasa S. Health related quality of life in the general Norwegian population assessed by the European Organization for research and treatment of cancer core quality -of-life question naire : The QLQ-C30(+3 ) . J Clin Oncol 1998 , 16 , 1188 - 1196 ) the prevalence of some symptoms was markedly less . Norm values for age and sex groups are given and regression analyses are performed which help to calculate expected mean scores . The results show that age and sex differences must be taken into consideration when different groups of cancer patients are compared . The norm values help to interpret quality of life data for clinicians Physical activity offers many benefits to breast cancer survivors , yet research on physical activity during the immediate period following a breast cancer diagnosis is limited . In a prospect i ve cohort study of 1,696 women diagnosed with invasive breast cancer in the Kaiser Permanente Northern California Medical Care Program from 2006–2009 , we describe change in self-reported physical activity levels from around diagnosis to 6 months post-diagnosis and determine factors associated with change . Participants completed a comprehensive physical activity question naire at baseline ( 2 months post-diagnosis ) and at follow-up ( 8 months post-diagnosis ) . Predictors of physical activity change were determined by multivariable linear regression . Reductions in all physical activity levels were observed ( P < 0.0001 ) ; mean ( SD ) change ( h/week ) of moderate-vigorous physical activity ( MVPA ) was −1.28 ( 4.48 ) and sedentary behavior was −0.83 ( 6.95 ) . In fully-adjusted models , overweight and obesity were associated with greater declines in MVPA of −1.58 h/week ( SD = 0.92 ) and −1.29 h/week ( SD = 0.93 ) , respectively ( P = 0.0079 ) . Receipt of chemotherapy only was also associated with a greater decrease in MVPA ( −2.12 h/week ; SD = 0.92 ; P < 0.0001 ) , specifically for recreational activities ( −1.62 h/week ; SD = 0.64 ; P = 0.0001 ) . These data suggest challenges in maintaining physical activity levels during active treatment among women with breast cancer . Interventions to encourage physical activity in breast cancer survivors should be pursued PURPOSE The 2000 National Institutes of Health Consensus Conference on Adjuvant Therapy of Breast Cancer recommended chemotherapy for all women with invasive cancer greater than 1 centimeter . Studies of long-term breast cancer survivors have found poorer quality of life ( QOL ) in women who received adjuvant chemotherapy .  The aim of this article is to characterize physical and psychosocial recovery as a function of chemotherapy receipt in the year after medical treatment completion . PATIENTS AND METHODS Prospect i ve longitudinal survey data ( R AND SF-36 and Breast Cancer Prevention Trial [ BCPT ] Symptom Scales ) collected from 558 women with breast cancer enrolled on the Moving Beyond Cancer ( MBC ) psychoeducational intervention trial were compared according to receipt of chemotherapy . MBC study enrollment occurred within 4 weeks after the end of primary treatment ( eg , surgery , chemotherapy , radiation ) . Self-report question naire data collected at enrollment and at 2 , 6 , and 12 months thereafter were examined , controlling for intervention and with propensity score adjustment for imbalance of covariates . Outcome analyses were carried out by fitting linear mixed models by using SAS PROC MIXED . RESULTS Longitudinal SF-36 scale scores did not differ by chemotherapy treatment exposure , and both groups improved significantly ( P < .01 ) in the year after primary treatment ended . However , adjuvant chemotherapy treatment was associated with significantly more severe physical symptoms , including musculoskeletal pain ( P = .01 ) , vaginal problems ( P < .01 ) , weight problems ( P = .01 ) , and nausea ( P = .03 ) . CONCLUSION Physical and psychosocial functioning improved significantly after breast cancer treatment , independent of receipt of adjuvant chemotherapy .  Women who received chemotherapy experienced more severe and persistent physical symptoms that should be more effectively managed as part of survivorship care Previous studies suggest that increased physical activity may lower the risk of breast cancer incidence , but less is known about whether levels of physical activity after breast cancer diagnosis can influence survival . We prospect ively examined the relation between postdiagnosis recreational physical activity and risk of breast cancer death  in women who had a previous invasive breast cancer diagnosed between 1988 and 2001 ( at ages 20 - 79 years ) . All women completed a question naire on recent  postdiagnosis physical activity and other lifestyle factors . Among 4,482 women without history of recurrence at the time of completing the question naire , 109 died from breast cancer within 6 years of enrollment .  Physical activity was expressed as metabolic equivalent task-hours per week ( MET-h/wk ) ; hazard ratios ( HR ) and 95 % confidence intervals ( 95 % CI ) were estimated using Cox proportional hazards regression . After adjusting for age at diagnosis , stage of disease , state of residence , interval between diagnosis and physical activity assessment , body mass index , menopausal status , hormone therapy use , energy intake , education , family history of breast cancer , and treatment modality compared with women expending < 2.8 MET-h/wk in physical activity , women who engaged in greater levels of activity had a significantly lower risk of dying from breast cancer ( HR , 0.65 ; 95 % CI , 0.39 - 1.08 for 2.8 - 7.9 MET-h/wk ; HR , 0.59 ; 95 % CI , 0.35 - 1.01 for 8.0 - 20.9 MET-h/wk ; and HR , 0.51 ; 95 % CI , 0.29 - 0.89 for ≥21.0 MET-h/wk ; P for trend = 0.05 ) . Results were similar for overall survival ( HR , 0.44 ; 95 % CI , 0.32 - 0.60 for ≥21.0 versus < 2.8 MET-h/wk ; P for trend < 0.001 ) and were similar regardless of a woman ’s age , stage of disease , and body mass index . This study provides support for reduced overall mortality and mortality from breast cancer among women who engage in physical activity  after breast cancer diagnosis . ( Cancer Epidemiol Biomarkers Prev 2008;17(2):379–86 BACKGROUND Studies on cognitive functioning in breast cancer patients point out that a subset of women exhibit chemotherapy-related neuropsychological impairment . Thereby , high-dose therapy may elevate the risk of cognitive dysfunctions . The primary purpose of the study was to evaluate the impact of high-dose versus st and ard-dose chemotherapy on the late neuropsychological outcome in r and omized assigned high-risk breast cancer survivors . Next to focusing prevalence , function specificity and extent of cognitive impairment , the question as to whether doses-dependent group differences occur was investigated . PATIENTS AND METHODS Twenty-four high-dose and 23 st and ard-dose patients 5 years , on average , after treatment underwent a comprehensive neuropsychological assessment . In addition , 29 early-stage breast cancer patients matched for age , education and time since treatment were recruited as a comparison group . RESULTS Global cognitive impairment was observed in 8 % of high-dose versus 13 % of st and ard-dose compared with 3 % of early-stage breast cancer patients . Compared with normative data , all patient groups performed worse on one attention subtest measuring the simple reaction time ( P < 0.001 in each case ) . By contrast , no significant between-group differences on the late neuropsychological outcome were found . CONCLUSIONS Five years after treatment , st and ard-dose patients were slightly , but not significantly , more impaired in cognitive performance than high-dose patients Background : In epidemiological studies abundant physical activity has been related to decreased  breast cancer  risk , though the results have been inconsistent . The purpose of this paper was to study the association of physical activity at leisure and commuting to work and incidence of breast cancer . Methods : The study cohort consisted of 30,548 female participants of the Finnish adult health behaviour survey , based on annual r and om sample s of Finns aged 15–64 , collected in 1978–1993 . By the end of 1995 , 332 breast cancer cases had been diagnosed in the cohort . Relative risks of breast cancer were adjusted for age at survey , body mass index ( BMI ) , education , length of follow-up , parity and age at first birth using Poisson regression models . Results : Compared to women exercising less than once a week , the adjusted relative risk of breast cancer for women exercising once a week was 0.80 ( 95 % confidence interval ( CI ) : 0.58–1.10 ) , for women exercising 2–3 times per week 0.92 ( 95 % CI : 0.78–1.22 ) and for women exercising daily 1.01 ( 95 % CI : 0.72–1.42 ) . Women who reported commuting , walking or bicycling to work 30 min or more daily had slightly lower adjusted risk of breast cancer ( RR : 0.87 , 95 % CI : 0.62–1.24 ) than women working at home , being unemployed or driving a car to working place . Conclusion : Although a small protective effect of regular physical activity for breast cancer incidence was found in physical activity when commuting to work , the role of the physical activity in breast cancer prevention is still an open question We examined breast  cancer  risk in association with overall glycemic index ( GI ) , glycemic load ( GL ) , and dietary carbohydrate and sugar intake in a prospect i ve cohort of 49,613 Canadian women enrolled in the National Breast Screening Study who completed a self-administered food frequency question naire between 1980 and 1985 . Linkages to national mortality and cancer data bases yielded data on deaths and cancer incidence , with follow-up ending between 1998 and 2000 . During a mean follow-up of 16.6 years , we observed 1,461 incident breast cancer cases . GI , GL , total carbohydrate and total sugar intake were not associated with breast cancer risk in the total cohort . However , there was evidence of effect modification of the association between GI and breast cancer risk by menopausal status ( p = 0.01 ) , the hazard ratio for the highest versus the lowest quintile level of GI being 0.78 ( 95 % CI = 0.52 - 1.16 ; ptrend = 0.12 ) in premenopausal women and 1.87 ( 95 % CI = 1.18 - 2.97 ; ptrend = 0.01 ) in postmenopausal women . The associations between GI and GL were not modified by body mass index ( BMI ) or by vigorous physical activity among pre- or postmenopausal women . Similarly , the associations between GI/GL and risk in postmenopausal women were not modified by BMI , vigorous physical activity , or ever use of hormone replacement therapy ( HRT ) , although the associations were slightly stronger among those who reported no vigorous physical activity ( ptrend = 0.02 ) , among those who reported ever using HRT ( ptrend = 0.02 ) and among normal-weight women ( BMI < 25 kg/m2 ; ptrend = 0.03 ) . Our data suggest that consumption of diets with high GI values may be associated with increased risk of breast cancer among postmenopausal women , possibly more so among subgroups defined by participation in vigorous physical activity , ever use of HRT and those who are not overweight BACKGROUND The incidence of breast cancer in young patients less than 35 years is less than 1 % . The physical and psychosocial morbidity may affect their ability to successfully function in their social roles . Hence we studied the  quality of life ( QOL )  issues in this subset . MATERIAL S AND METHODS Younger women with age less than 35 years , diagnosed with non-metastatic breast cancer at our Institute , from 1995 to 2005 , were included in the study .  Quality of life issues were studied during the follow-up using EORTC QOL C30 and BR23 . Descriptive and inferential statistics were used in order to analyze the data . RESULTS A total of 51 patients were included for the study . The mean age at diagnosis was 30 years . The effect of breast cancer on the occupation and marital status was minimal . The global health status and the functional scores were high , while the overall sexual function was lower . The global health status was higher in the mastectomy group . The arm symptoms ( P = 0.027 ) and pain were higher in the Breast conservation surgery ( BCS ) group . The sexual symptoms appeared to be higher in the ovary ablated group when compared to the ovary preserved group . The sexual functional scores ( P = 0.02 ) and sexual enjoyment scores ( P = 0.003 ) were better in the mastectomy group . CONCLUSION The overall QOL in younger patients with breast cancer appeared to be good . The QOL and sexual function were marginally worse in the breast conservation group when compared to mastectomy group BACKGROUND . A r and omized controlled trial was conducted to investigate the efficacy of classical massage treatment in reducing breast cancer-related symptoms and in improving mood disturbances . METHODS . Women diagnosed with primary breast cancer were r and omized into an intervention group and a control group . For a period of 5 weeks , the intervention group received bi-weekly 30-min classical massages in the back and head-neck areas . The control group received no additional treatment to their routine healthcare . To evaluate treatment efficacy , the following vali date d question naires were administrated at baseline ( T1 ) , at the end of the intervention ( T2 ) , and at a followup at 11 weeks ( T3 ) : the Short Form-8 Health Survey , the European Organization of Research and Treatment of Cancer quality of life question naire breast module ( EORTC QLQ-BR23 ) , the Giessen Complaints Inventory ( GBB ) , and the Berlin Mood Question naire ( BSF ) . RESULTS . Eighty-six eligible women ( mean age : 59 years ) were enrolled in the study . A significantly higher reduction of physical discomfort was found in the intervention group compared with the control group at T2 ( p=0.001 ) and at T3 ( p=0.038 ) . A decrease in fatigue was also observed . Women in the intervention group reported significantly lower mood disturbances at T2 ( p<0.01 ) but not at T3 . The effect of treatment on mood disturbances was significantly higher if a patient was treated continuously by the same masseur . CONCLUSION . Classical massage seems to be an effective adjuvant treatment for reducing physical discomfort and fatigue , and improving mood disturbances in women with early stage breast cancer Objective To compare breast cancer incidence and mortality up to 25 years in women aged 40 - 59 who did or did not undergo mammography screening .  Design Follow-up of r and omised screening trial by centre coordinators , the study ’s central office , and linkage to cancer registries and vital statistics data bases . Setting 15 screening centres in six Canadian provinces,1980 - 85 ( Nova Scotia , Quebec , Ontario , Manitoba , Alberta , and British Columbia ) . Participants 89 835 women , aged 40 - 59 , r and omly assigned to mammography  ( five annual mammography screens ) or control ( no mammography ) . Interventions Women aged 40 - 49 in the mammography arm and all women aged 50 - 59 in both arms received annual physical breast examinations . Women aged 40 - 49 in the control arm received a single examination followed by usual care in the community . Main outcome measure Deaths from breast cancer . Results During the five year screening period , 666 invasive breast cancers were diagnosed in the  mammography arm ( n=44 925 participants ) and 524 in the controls ( n=44 910 ) , and of these , 180 women in the mammography arm and 171 women in the control arm died of breast cancer during the 25 year follow-up period . The overall hazard ratio for death from breast cancer diagnosed during the screening period associated with mammography was 1.05 ( 95 % confidence interval 0.85 to 1.30 ) . The findings for women aged 40 - 49 and 50 - 59 were almost identical . During the entire study period , 3250 women in the mammography arm and 3133 in the control arm had a diagnosis of breast cancer , and 500 and 505 , respectively , died of breast cancer . Thus the cumulative mortality from breast cancer was similar between women in the mammography arm and in the control arm ( hazard ratio 0.99 , 95 % confidence interval 0.88 to 1.12 ) . After 15 years of follow-up a residual excess of 106 cancers was observed in the mammography arm , attributable to over-diagnosis . Conclusion Annual mammography in women aged 40 - 59 does not reduce mortality from breast cancer beyond that of physical examination or usual care when adjuvant therapy for breast cancer is freely available . Overall , 22 % ( 106/484 ) of screen detected invasive breast cancers were over-diagnosed , representing one over-diagnosed breast cancer for every 424 women who received mammography screening in the trial Few studies have assessed quality of life ( QOL ) of women diagnosed with breast cancer within the first few weeks of their initial diagnosis . We describe QOL among 950 women recently diagnosed with invasive breast cancer . Starting in January 2006 , we invited women aged ≥21 years who were diagnosed with first primary invasive breast cancer within Kaiser Permanente Northern California ( KPNC ) to enroll in the Pathways Study , a prospect i ve study of breast cancer survivorship . QOL was measured using the Functional Assessment of Cancer Therapy-Breast Cancer ( FACT-B )  , along with sociodemographic and social support information . Clinical characteristics were obtained from the KPNC cancer registry and electronic medical record . We used multivariable linear regression models to identify factors associated with QOL scores calculated from the FACT-B. The mean age ± SD of the sample was 59.6 years ( ±11.9 years ) , and the mean time ±SD from diagnosis until interview was 8.0 weeks ( ±3.2 weeks ) . Younger age at diagnosis was associated with lower scores in all QOL domains ( P < 0.01 ) , and later stage at diagnosis was associated with lower scores in all domains ( P < 0.05 ) except for social well-being . Higher levels of social support were associated with higher QOL except for physical well-being ( P < 0.05 ) . These associations were stronger within 2 months of breast cancer diagnosis . Quality of life as influenced by a diagnosis of breast cancer is an important factor in cancer survivorship . Age , stage at diagnosis , and social support are key factors in this important variable Purpose After cancer treatment , it is desirable to maintain or regain a high quality of life ( QoL ) and the ability to accomplish everyday tasks well . Therefore , we substantiated the scarce knowledge regarding long-term QoL after breast cancer , burdensome problems , and unmet needs for more support . Methods Disease-free breast cancer survivors ( n = 190 ) who had participated in two r and omized controlled exercise trials during primary treatment were followed up to 5 years post-diagnosis .  QoL-related functions and symptoms ( EORTC QLQ-C30/-BR23 ) , health problems , and support needs were assessed . EORTC-QLQ scores were compared with age-matched normative values from the general population in Germany . Results QoL-related functions and symptoms in patients during cancer treatment were worse compared to healthy references , but largely improved over time . Yet , cognitive function and sleep were still significantly impaired at 5-year follow-up . Other common long-term problems included sexual issues ( 45 % of survivors ) , hot flashes ( 38 % ) , pain ( 34 % ) , fatigue ( 24 % ) , and polyneuropathy ( 21 % ) . Regression analyses indicated fatigue having the strongest impact on global QoL. Support needs were expressed mainly for menopausal disorders ( 43 % ) , physical performance ( 39 % ) , sleep problems ( 38 % ) , arthralgia ( 37 % ) , cognitive problems ( 36 % ) , weight problems ( 32 % ) , and fatigue ( 31 % ) . Conclusions While QoL in disease-free breast cancer survivors 5 years post-diagnosis was largely comparable to the general population on average , still many survivors suffered from adverse effects . There appears to be a need for ongoing screening and support regarding fatigue , sleep problems , cognitive problems , arthralgia/pain , menopausal/sexual symptoms , physical performance , and weight problems during and several years following breast cancer therapy
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 ?