A systematic review of quality of life instruments in long-term breast cancer survivors

A systematic literature search was conducted from January 1990 to October 2010 using electronic databases. Instruments validated and used in BCS were included in the review. In addition, QoL studies in long-term BCS using the validated instruments were reviewed. The search was limited to studies in English language. Studies of BCS of less than five years after initial diagnosis, any clinical or review studies were excluded.The review identified a total of 12 instruments (10 disease-specific, 2 condition-specific) validated in long-term BCS. According to the QoL framework proposed by Ferrell and colleagues, three instruments (Quality of Life-Cancer Survivors, Quality of Life in Adult Cancer Survivors Scale, and Quality of Life Index-Cancer Version) evaluated all four domains (physical, psychological, social, and spiritual) of QoL. A review of the psychometric evaluation showed that Quality of Life in Adult Cancer Survivors Scale has acceptable reliability, validity, and responsiveness in long-term BCS compared to other disease-specific instruments. The review also yielded 19 studies that used these QoL instruments. The study results indicated that age-group, ethnicity, and type of treatment influenced different aspects of QoL.There is a significant impact of breast cancer on QoL in long-term BCS. The review can help researchers and clinicians select the most appropriate instruments to assess the changes in QoL in BCS.Breast cancer is the most common cancer in women, representing 16% of all female cancers [1]. Approximately 200,000 new cases of breast cancer are diagnosed each year in the United States (US) [2]. Most significant risk factors for the disease include age, gender, and race/ethnicity [3]. Breast cancer incidence and death rates generally increase with age; women older than 45 years are at the greatest risk [3]. In developed countries, there has been a significant decline in the mortality rate due to improved diagnosis and treatment programs. The National