Association of quality of life in older patients with breast cancer: a cross-sectional study from China

Objectives The purpose of this study was to investigate the quality of life (QoL) of older Chinese patients with breast cancer and to explore further the associations of functions, symptoms, financial burdens and comorbidities with global health/quality of life (gQoL). Design This was a cross-sectional study carried out following the Strengthening the Reporting of Observational Studies in Epidemiology checklist. Setting This study was conducted in two hospitals in Beijing from October 2021 to November 2022. Participants Patients with breast cancer aged over 65 years were included in the final analysis, which comprised a total of 481 patients. Primary and secondary outcome measures The European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 and the Charlson Comorbidity Index (CCI) were used to assess patients’ QoL and comorbidities. The data were analysed using network analysis and path analysis. Results Out of the 136 possible edges in the final networks, 84 (61.8%) were non-zero. ‘Fatigue’ was the central symptom and indirectly decreased the gQoL, which was mediated by increasing ‘financial difficulties’, ‘CCI’ and ‘role function’ (β = −0.35, p<0.001). ‘Physical function’ was also an important and direct intervention node that was indirectly related to gQoL, and this was mediated by ‘role function’ (β = −0.15, p=0.006). Path analysis accounted for 32.0% of the total effect. Conclusions The various dimensions of QoL are highly interrelated and mutually reinforcing. These results highlight the importance of improving the fatigue and physical function of older patients with breast cancer. Interventions targeting these symptoms may lead to an overall improvement in gQoL. Trial registration number ChiCTR2200056070; Public title: Frailty and Comorbidity in the Elderly Study (FACE Study).