Functional Impact of Breast Cancer by Age at Diagnosis

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Abstract
Purpose To explore changes in physical and psychosocial function before and after breast cancer by age at diagnosis. Patients and Methods A total of 122,969 women from the Nurses' Health Study (NHS) and NHS 2, ages 29 to 71 years, who responded to pre- and postfunctional status assessments were included; 1,082 women were diagnosed with breast cancer between 1992 and 1997. Functional status was measured using the Medical Outcomes Study Short Form 36 (SF-36). Mean change in health-related quality of life (HRQoL) scores was computed across categories representing the combination of incident breast cancer (yes or no) and age at diagnosis (≤ 40, 41 to 64, or 65+ years). Results Compared with women ≤ 40 years without breast cancer, women with breast cancer experienced significant functional declines. Young (age ≤ 40) women who developed breast cancer experienced the largest relative declines in HRQoL (as compared with middle-aged and elderly women) in multiple domains including physical roles (−18.8 v −11.5 and...