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Comparison of younger and older breast cancer survivors and age‐matched controls on specific and overall quality of life domains
Open accessAbstract
BACKGROUND: Younger survivors (YS) of breast cancer often report more survivorship symptoms such as fatigue, depression, sexual difficulty, and cognitive problems than older survivors (OS). This study sought to determine the effect of breast cancer and age at diagnosis on quality of life (QoL) by comparing 3 groups: 1) YS diagnosed at age 45 years or before, 2) OS diagnosed between 55 and 70, and 3) for the YSs, age‐matched controls (AC) of women not diagnosed with breast cancer. METHODS: Using a large Eastern Cooperative Oncology Group (ECOG) database, 505 YS were recruited who were aged 45 years or younger when diagnosed and 622 OS diagnosed at 55 to 70 years of age. YS, OS, and AC were compared on physical, psychological, social, spiritual, and overall QoL variables. RESULTS: Compared to both AC and to OS, YS reported more depressive symptoms ( P = .005) and fatigue ( P < .001), poorer self‐reported attention function ( P < .001), and poorer sexual function ( P < .001) than either comparison group. However, YS also reported a greater sense of personal growth ( P < .001) and perceived less social constraint ( P < .001) from their partner than AC. CONCLUSIONS: YS reported worse functioning than AC relative to depression, fatigue, attention, sexual function, and spirituality. Perhaps even more important, YS fared worse than both AC and OS on body image, anxiety, sleep, marital satisfaction, and fear of recurrence, indicating that YS are at greater risk for long‐term QoL problems than survivors diagnosed at a later age. Cancer 2014;120:2237–2246. © 2014 American Cancer Society .
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“For many YA cancer survivors, the impact of treatment is significant and long-lasting, including difficult physical symptoms (e.g., pain, fatigue) [4–6], psychological distress [6–10], and an increased risk of long-term health problems (e.g., second cancers, early-onset cardiovascular disease) [11–13].”
From Improving symptom management for survivors of young adult cancer: rationale and study protocol for a pilot randomized controlled trial (2024) · cites this paper as [6]
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BackgroundLife after breast cancer: ‘Being’ a young African American survivor
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“Most prior research has either compared depression symptoms across age groups [46–48] or investigated the prevalence of depressive symptoms in older patients exclusively [49–52], showing that older women with breast cancer experience subsequent depression to a lesser extent than younger counterpart.”
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“유방암 생존자는 치료로 인한 신체적 변화와 함께, 우울, 불안, 수면 장애, 재발에 대한 두려움과 불안 같은 심리적 디스트레스 및 배우자와의 낮은 결혼 만족도 등의 문제들로 인해 우울을 경험한다고 하였다 [9,22,23].”
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“Furthermore, younger patients showed greater personal growth (Champion et al., 2014).”
BackgroundSocio-Ecological Environmental Characteristics of Young Chinese Breast Cancer Survivors
Hu, Y., Xu, J., Wang, X., Shi, Y., Chen, M., & Im, E. (2021) · Oncology nursing forum · doi:10.1188/21.onf.481-490 · Cited by 8
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Hwang, Y., Conley, S., Jeon, S., Redeker, N. S., Sanft, T. B., & Knobf, M. T. (2022) · Research in Nursing & Health · doi:10.1002/nur.22264 · Cited by 8
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Changes of Symptom Distress and Quality of Life in Breast Cancer Patients Receiving Adjuvant Therapy
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Villarreal-Garza, C. M., Platas, A., Ávila, M. M., Mesa-Chávez, F., García-García, M., Fonseca, A., Pineda, C., de la Rosa-Pacheco, S., Gálvez‐Hernández, C. L., Bargalló‐Rocha, E., et al. (2020) · Supportive Care in Cancer · doi:10.1007/s00520-020-05334-y · Cited by 6
“Moreover, YWBC have greater supportive care needs than their older counterparts and may thus appreciate to a higher degree the provision of complementary resources [25, 26].”
BackgroundMexican consensus on breast cancer diagnosis and treatment
Cárdenas-Sánchez, J. (2021) · Gaceta Mexicana de Oncología · doi:10.24875/j.gamo.m21000215 · Cited by 6
Characterizing Early Changes in Quality of Life in Young Women With Breast Cancer
Al‐Kaylani, H. M., Loeffler, B. T., Mott, S. L., Curry, M. A., Phadke, S. D., & van der Plas, E. A. A. (2022) · Frontiers in Psychology · doi:10.3389/fpsyg.2022.871194 · Cited by 6
“Finally, most research efforts to date have focused on longterm outcomes (Champion et al., 2014; Cohee et al., 2017; Dominici et al., 2021; Roine et al., 2021).”
BackgroundInfluentialEllis, K. R., Koechlin, H., Rudaz, M., Gerido, L. H., Hecht, H. K., Jones, C. R., Raji, D., Northouse, L., & Katapodi, M. C. (2024) · Cancer Medicine · doi:10.1002/cam4.70328 · Cited by 5
Vaca‐Cartagena, B. F., Ferrigno, A. S., Azim, H. A., Rotolo, F., Olivas‐Martínez, A., Platas, A., Fonseca, A., Mesa-Chávez, F., Cruz‐Ramos, M., Rodriguez, A., et al. (2024) · The Breast · doi:10.1016/j.breast.2024.103866 · Cited by 5
“For instance, compared to older patients, YWBC have a poorer body image and overall QoL [40], which could further decline due to the aggressive treatment strategies they receive.”
Dorfman, C. S., Stalls, J. M., Lachman, S. E., Shelby, R. A., Somers, T. J., & Oeffinger, K. C. (2022) · Journal of Adolescent and Young Adult Oncology · doi:10.1089/jayao.2021.0172 · Cited by 5
Lee, K., & Jun, H. S. (2023) · European Journal of Oncology Nursing · doi:10.1016/j.ejon.2023.102496 · Cited by 5
Valvi, N. R., Tamargo, J. A., Braithwaite, D., Fillingim, R. B., & Karanth, S. D. (2024) · Cancers · doi:10.3390/cancers16162847 · Cited by 5
“Among these effects, chronic pain has emerged as a particularly prevalent symptom, profoundly impacting their quality of life [3–5].”
BackgroundZhou, K., Wang, D., He, X., Huo, L., An, J., Li, M., Wang, W., & Li, X. (2016) · BMC Cancer · doi:10.1186/s12885-016-2726-y · Cited by 5
Quality of Life in Breast Cancer Survivors: A Meta‐Analysis of Case‐Control Studies
Huang, Y., Xing, H.-Q., Yan, Y., Wang, Y., Feng, Y., Smith, R. D., Su, Z., Cheung, T. C. C., Ungvari, G. S., Jackson, T., et al. (2026) · Psycho-Oncology · doi:10.1002/pon.70398 · Cited by 7
Robins, V. R., Gelcich, S., Absolom, K. L., & Velikova, G. (2024) · The Breast · doi:10.1016/j.breast.2024.103734 · Cited by 4
“[72,62,70,77, 79,87] found that age did not have a significant impact on physical functioning.”
BackgroundKorecki, J. R., Ganz, P. A., Partridge, A. H., Wolff, A. C., Petersen, L., Crespi, C. M., & Bower, J. E. (2024) · JCO Oncology Practice · doi:10.1200/op.23.00617 · Cited by 4
Duan, Y., Zhou, T., Chen, J., Zhang, J., Chen, Y., Sun, Q., Cai, T., & Yuan, C. (2025) · Healthcare and Rehabilitation · doi:10.1016/j.hcr.2025.100050 · Cited by 4
A Decision Tree Analysis on the Impact of a Technology-Based Program on Symptom Distress
Im, E., Yi, J., & Chee, W. (2021) · CIN Computers Informatics Nursing · doi:10.1097/cin.0000000000000825 · Cited by 4
Lyons, K. S., Firkins, J., Hanan, D. M., Hansen, L., & Hayes-Lattin, B. (2022) · Cancer Nursing · doi:10.1097/ncc.0000000000001028 · Cited by 4
Vachon, E. A., Krueger, E., Haggstrom, D. A., & Champion, V. L. (2024) · Healthcare · doi:10.3390/healthcare12020134 · Cited by 4
“In the long-term, BCSs report long-term physical, psychological, social, and spiritual difficulties [4].”
BackgroundInfluentialSelf-citationWarrington, L., Absolom, K. L., Baxter, P. D., Bojke, C., Clarke, G., Crossfield, S. S. R., Johnston, C., Martin, A., McInerney, C. D., Saalmink, G., et al. (2024) · Journal of Cancer Survivorship · doi:10.1007/s11764-024-01708-x · Cited by 4
“However, some positive differences have also been found such as higher levels of post-traumatic growth and greater social support [13, 14].”
Predictors of Quality of Life in Young Adults Diagnosed With Cancer
McKie, C., & Laiyemo, A. O. (2020) · Clinical Nursing Research · doi:10.1177/1054773820928197 · Cited by 4
“While fertility and sexuality related concerns are commonly reported by AYAs diagnosed with cancer (Champion et al., 2014; Sodergren et al., 2017; Wettergren et al., 2016), these were not included in the inventory.”
BackgroundÁvila, M. M., de la Rubia, J. M., Fonseca, A., Ramos, M. C., Villarreal-Garza, C. M., Gaitán, A. B., Vaca‐Cartagena, B. F., & Ferrigno, A. S. (2021) · Psicooncología · doi:10.5209/psic.77755 · Cited by 4
“Psicooncología 2021; 18(2): 293-316 297”
BackgroundInfluentialInfluence of Age on Health-Related Quality of Life of Women Diagnosed with Breast Cancer
dos Santos, L. N., de Aguiar, S. S., Rodrigues, G. M., Thuler, L. C. S., & Bergmann, A. K. (2023) · Revista Brasileira de Cancerologia · doi:10.32635/2176-9745.rbc.2023v69n2.3826 · Cited by 4
Distress among cancer patients attending rehabilitation in the community
Kuo, A. (2021) · Supportive Care in Cancer · doi:10.1007/s00520-021-06422-3 · Cited by 4
Dorfman, C. S., Shelby, R. A., Stalls, J. M., Thomas, S. M., Arrato, N. A., Herold, B., Somers, T. J., Keefe, F. J., Winger, J. G., Vilardaga, J. P., et al. (2024) · Pilot and Feasibility Studies · doi:10.1186/s40814-024-01510-7 · Cited by 3
“The study biostat-istician was consulted to develop a new randomization scheme for cohorts 2–6.”
BackgroundMethodVaca‐Cartagena, B. F., Mesa-Chávez, F., Ferrigno, A. S., Azim, H. A., Rotolo, F., Platas, A., Fonseca, A., Cruz‐Ramos, M., Rodriguez, A., Mohar, A., et al. (2025) · Therapeutic Advances in Medical Oncology · doi:10.1177/17588359251337493 · Cited by 3
“11,12 While the most significant decline in QoL occurs during active treatment phases, 10,13,14 recovery to base-line levels often takes longer in YWBC than in older patients.”
Orozco, M. R., Vazquez, O., Rocha, J. E. B., Costas-Muñíz, R., Bernal, L., & García, A. M. (2022) · Psicología y Salud · doi:10.25009/pys.v32i2.2752 · Cited by 3
Zamir, T., Statman, M. R., Sleiman, M. M., Fleischmann, A., Silber, E., & Tercyak, K. P. (2024) · Healthcare · doi:10.3390/healthcare12222317 · Cited by 3
Post-mastectomy wound care – need for an empathetic approach
Sangavi, C., Kollarmalil, R., & Abraham, S. (2025) · Psychology Health & Medicine · doi:10.1080/13548506.2025.2490229 · Cited by 4
“Women under 50 years old were more likely to report psychological distress in comparison to their counterparts aged over 50 (Champion et al., 2014; Howard-Anderson et al., 2012).”
Quality of life in long-term cancer-free breast cancer survivors in spain: A descriptive study
Soto‐Ruiz, N., Escalada‐Hernández, P., Parra, G., & García‐Vivar, C. (2025) · Scientific Reports · doi:10.1038/s41598-025-10176-x · Cited by 5
“Factors such as persistent side effects, social support, socioeconomic status and self-efficacy with respect to disease management significantly influence the ability of LT-BCSs to adapt and recover 7 .”
Turgay, T., Karadeniz, P. G., & Maralcan, G. (2021) · Archives of Breast Cancer · doi:10.32768/abc.202182119-126 · Cited by 3
Coping strategies among middle-aged and older cancer survivors in Japan: A qualitative study
Yi, X., & Kase, H. (2022) · International Social Work · doi:10.1177/00208728211068933 · Cited by 3
“Although previous research has stated that older cancer survivors reported less posttraumatic growth (Champion et al., 2014; Kahana et al., 2016), in this study, 11 respondents (A, B, C, E, G, I, K, L, N, O, P) reported perceived positive changes after adaptations.”
ResultTomić, S. D., Malenković, G., Šljivo, A., Mujičić, E., & Tomić, S. (2023) · Healthcare · doi:10.3390/healthcare11243184 · Cited by 3
Metadata
- Authors
- Champion, V. L., Wagner, L. I., Monahan, P. O., Daggy, J., Smith, L., Cohee, A., Ziner, K. W., Haase, J. E., Miller, K. D., Pradhan, K., Unverzagt, F. W., Cella, D., Ansari, B., & Sledge, G. W.
- Affiliations
- Indiana University Indianapolis (US)
- Northwestern University (US)
- IU Health Physicians Indianapolis Indiana
- Indiana University Health (US)
- Northern Indiana Cancer Research Consortium (US)
- Corresponding author
- Champion, Victoria L.
- ORCID
- Venue
- Cancer
- Publisher
- Wiley
- Published
- 2014-05-28
- Volume
- 120
- Issue
- 15
- Pages
- 2237-2246
- ISSN
- 0008-543X (ISSN-L)
- 1097-0142
- PMC
- PMC4158315
- OpenAlex
- W1531255325
- Cited by
- 278
- References
- 52
- Citations by year
- 2026: 17 · 2025: 15 · 2024: 24 · 2023: 23 · 2022: 38 · 2021: 35 · 2020: 24 · 2019: 28 · 2018: 25 · 2017: 17 · 2016: 10 · 2015: 18 · 2014: 4
- FWCI
- 7.89
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Cancer (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- IUScholarWorks (Indiana University) (submittedVersion, other-oa)
- Purdue University Indianapolis (Indiana University) (submittedVersion, other-oa)
- Funders
- American Cancer Society (RSGPB-04-089-01-PBP)
- Topics
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Childhood Cancer Survivors' Quality of Life
- Health Sciences › Medicine › Oncology › Cancer-related cognitive impairment studies
- Keywords
- breast cancer survivors, young age at diagnosis, age at diagnosis, quality of life, depressive symptoms, fatigue, sexual function, cognitive function, attention, body image, anxiety, sleep, marital satisfaction, fear of recurrence, spirituality, personal growth, social constraints
- MeSH terms
- Age Factors, Aged, Breast Neoplasms, Female, Humans, Middle Aged, Quality of Life, Survivors
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