Abstract P1-17-04: Health related quality of life at the end of acute treatments for early stage breast cancer patients
Authors: Billa Oumar , Dialla Olivia , Dauchy Sarah , Pistilli Barbara , Cottu Paul-Henri , Lesur Anne , Lerebour Florence , Tredan Olivier , Vanlemmens Laurence , Jouannaud Christelle , Levy Christelle , Cecile Charles , Martin Anne Laure , Everhard Sibille , Joly Florence , Coutant Charles , Andre Fabrice , Arveux Patrick , Dabakuyo-Yonli Sandrine 
Published: March 2020

Abstract
Background: Nowadays, the assessment of health related quality of life (HRQOL) in women with breast cancer (BC) has become very important, with the improvement of their prognosis and the growing number of BC survivors. HRQOL is therefore a main endpoint in cancer therapeutic care and its improvement should be an important goal of BC treatment. The aim of this study was to assess HRQOL at the end of acute treatment in BC patients using data of the multicenter prospective French CANTO cohort.
Methods: CANTO (NCT 01993498) is a multicenter prospective observational study (26 centers in France) whose main objective is to study the chronic toxicities of anticancer treatments in 12,000 women with localized stages I to III BC. HRQOL was assessed at baseline and at the end of acute treatments (surgery +/- radiotherapy +/- chemotherapy) using the EORTC-QLQ-C30 questionnaire and its BC specific module, the EORTC-QLQ-BR23 questionnaire. The EORTC-QLQ-C30 is composed of 30 items which allow generating 15 scales which are: 5 functional scales, 8 symptom scales, a global health status and a financial difficulties scale. The EORTC-QLQ-BR23 comprises 23 items and contains 4 functional scales and 4 symptoms scales. The minimal clinically important change score (MCID) was defined as a mean difference of at least 10 points in HRQOL scores between the baseline and the end of acute treatments (M0). Mixed linear model was used to assess the determinants of HRQOL For the dimensions with MCID.
Results: from March 2012 to December 2014, 5801 BC patients were included in the CANTO cohort. The mean age at diagnostic was 57 years (SD=11.5) and 22.1 % of patients was single. Ninety percent of women had a good performance status and 79 % did not have comorbidities. Most of patients underwent surgery (99.7%), among which 77% by conservative surgery, and respectively 90.3 % were treated with radiotherapy, 80.2 % with hormone therapy and 53.3 with chemotherapy. Out of 23 dimensions, treatments for the disease did not impact the HRQOL of patients for global health status and 17 others dimensions of the QLQ-C30 and QLQ-BR23. However, with the means change score (MD) over 10 points, body image functional scale (MD= -14, p&lt;0.0001) and 4 symptoms scales: pain (MD= +11, p&lt;0.0001), breast symptoms (MD=+12, p&lt;0.0001), arm symptoms (MD=11, p&lt;0.0001) and upset by hair loss (MD=+12, p&lt;0.0001) were negatively impacted. In multivariate analysis, overweight, anxiety, depression and chemotherapy, were the main determinants which negatively impacted HRQOL for the body image dimension, pain symptoms, breast symptoms, arm symptoms and upset by hair loss. Hormonal status and education level were independent predictors of an improvement in HRQOL for the body image dimension and arm symptoms.
Conclusion: Results of this study did not show an impact of acute treatments for early stage BC on global health status of patients. The most affected dimensions, by the treatments, were body image, pain, breast symptoms, arm symptoms and upset by hair loss. Overweight, anxiety, depression, education level, hormonal status and chemotherapy were the main determinant of HRQOL.
Citation Format: Oumar Billa, Olivia Dialla, Sarah Dauchy, Barbara Pistilli, Paul-Henri Cottu, Anne Lesur, Florence Lerebour, Olivier Tredan, Laurence Vanlemmens, Christelle Jouannaud, Christelle Levy, Charles Cecile, Anne Laure Martin, Sibille Everhard, Florence Joly, Charles Coutant, Fabrice Andre, Patrick Arveux, Sandrine Dabakuyo-Yonli. Health related quality of life at the end of acute treatments for early stage breast cancer patients [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr P1-17-04.