With numerous treatment advances, many breast cancer patients can expect to be long-term survivors; however, quality of life, including potential loss of fertility after treatment, is an important consideration when making such treatment decisions.
This study hypothesised that young women with good prognosis hormone dependent breast cancer had better quality of life outcomes, fewer side effects and less decisional regret when choosing Goserelin, compared with women choosing chemotherapy.
Materials and methods
Pre-menopausal women aged 47 years or younger with good prognosis breast cancer were identified across five Australian treatment centres.
A total of 28 women participated, after choosing their treatment (adjuvant systemic chemotherapy and Tamoxifen or endocrine only therapy with Goserelin and Tamoxifen).
Study participants completed a number of quality of life questionnaires (FACT-B and FACT-ES; FSAQ and GMS) and a demographic questionnaire at study entry, 6, 12 and 24 months. Decision conflict was measured at study entry and decision regret at the end of the 2-year study period.
Semi-structured telephone interviews were also conducted with as many participants as possible and analysed to identify common themes using thematic analysis.
The main analysis was based on a longitudinal mixed model regression analysis with maximum likelihood estimation over four repeat observations (study entry, 6, 12 and 24 months). Multivariable longitudinal linear mixed models and linear random effects models were used as this approach is resistant to bias from missing values.
While the overall sample size was relatively small, a number of insights and useful information were surmised. Overall, quality of life was an issue for all participants over the two year period, not just Goserelin participants.
Survival was a major factor influencing the decision making process for participants, whether for the participants’ own benefits or, for many, their families as well. Women who had children were more likely to accept the treatment recommended by their clinician, particularly for those with older or grown up children, suggesting they would deal with side effects only ‘if and when’ they were an issue.
|Publication status||Unpublished - 2013|