Cited by 830Cancer survivorship and careChildhood Cancer Survivors' Quality of LifeWomen's cancer prevention and management

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Quality of Life, Fertility Concerns, and Behavioral Health Outcomes in Younger Breast Cancer Survivors: A Systematic Review

Howard-Anderson, J., Ganz, P. A., Bower, J. E., Stanton, A. L.·2012·JNCI Journal of the National Cancer Institute

DOI 10.1093/jnci/djr541

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Abstract

BACKGROUND: Breast cancer is the most common cancer in women younger than age 50 years. Cancer treatments in younger women may cause premature menopause, infertility, and negative psychosocial effects. In this systematic review, we examined three key domains of functioning that are particularly relevant for younger breast cancer survivors: health-related quality of life (QOL), menopausal symptoms and fertility concerns, and behavioral health outcomes. METHODS: We conducted a literature review using PubMed and secondary sources and examined 840 articles published between January 1990 and July 2010. Inclusion criteria for articles were 1) published in English after 1989; 2) exclusively analyzed female breast cancer survivors aged 50 years or younger or premenopausal at diagnosis, with baseline characteristics and/or quantitative or descriptive analyses for this age group; 3) investigated QOL (health-related QOL including physical functioning and mental health, depression, and anxiety), menopause- or fertility-related concerns, and weight gain or physical activity-related behavioral health outcomes. Data were extracted using a standardized table collecting the purpose, design, population, and results of each study. Extracted data were reviewed for accuracy by two investigators and presented as descriptive tables. RESULTS: A total of 28 articles met the inclusion criteria (15 cross-sectional studies, eight longitudinal studies, and five randomized trials). Regarding data review, no discordance between investigators was noted. Standardized measures of QOL and depressive symptoms identified worse outcomes as being more frequent or severe in breast cancer survivors aged 50 years or younger when compared with the general age-matched population of women without cancer and to older women (aged >50 years) with breast cancer. Concerns about premature menopause, menopausal symptoms, and infertility were common in younger women (aged ≤ 50 years) and had a role in the level of distress after treatment. Weight gain and physical inactivity were common health outcomes in younger women. CONCLUSIONS: Younger women with breast cancer were found to experience distinct psychosocial and menopause-related concerns, weight gain, and physical inactivity. A need for more longitudinal research, including efforts at intervention to manage these symptoms and adverse health outcomes, remains.

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“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).”
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Understanding Gender Inequality in Poverty and Social Exclusion through a Psychological Lens
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InfluentialSelf-citation
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“51 In contrast to AIs, tamoxifen ’ s action on ERs in the vaginal mucosa may vary by estrogen milieu, acting as an agonist in postmenopausal women and an antagonist in premenopausal patients.”
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“Although pregnancy in such cases might be considered as a victory over the disease, BRCA1/2 carriers maintain a sense of future threat regarding themselves and their children (Adams et al. , 2011; Canada and Schover, 2012; Howard-Anderson et al. , 2012).”
Fertility Preservation in BRCA Carriers: Special Considerations
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“For BCS of childbearing age, these attitudes impact already existing partnered relationships and prospective future relationships, especially if having children is desired (Avis et al., 2005; Howard-Anderson et al., 2012).”
BackgroundInfluential
Determining the psychometric properties of the Greene Climacteric Scale (GCS) in women previously treated for breast cancer: A pooled analysis of data from the Women's Wellness after Cancer Programs.
Seib, C., McCarthy, A., McGuire, A., Porter-Steele, J., Balaam, S., McDonald, N., Bailey, T., & Anderson, D. (2022) · Maturitas · doi:10.1016/j.maturitas.2022.02.003 · Cited by 2
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Background
Depression and Anxiety Symptoms Before and After Breast-Cancer Diagnosis Among Young Women in the Northern Finland Birth Cohort 1966
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“For these patients, a greater emotional burden is known to promote higher rates of suicide, lower medication adherence, as well as functional impairments in work, family, and social domains (Howard-Anderson et al., 2012; McFarland et al., 2019; Mausbach et al., 2015; Zaorsky et al., 2019).”
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“Apparently patients with cancer and psychological symptoms and depression have a poorer LS [14] and patients with BC have generally a high incidence of depression and anxiety and a reported low LS [31].”
Background
Gender and Personality Research in Psychology
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Five to seven years after breast cancer treatment, over a third of women (37%) report persistent pain
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Authors: Howard-Anderson, J., Ganz, P. A., Bower, J. E., & Stanton, A. L.
Affiliations: University of California, Los Angeles (US)
ORCID: Howard-Anderson, J.
Ganz, P. A.
Bower, J. E.
Stanton, A. L.
Venue: JNCI Journal of the National Cancer Institute
Publisher: Oxford University Press (OUP)
Published: 2012-01-23
Volume: 104
Issue: 5
Pages: 386-405
ISSN: 0027-8874 (ISSN-L)
1460-2105
DOI: 10.1093/jnci/djr541
OpenAlex: W2109496096
Cited by: 830
References: 99
Citations by year: 2026: 35 · 2025: 44 · 2024: 38 · 2023: 49 · 2022: 55 · 2021: 69 · 2020: 125 · 2019: 62 · 2018: 75 · 2017: 67 · 2016: 60 · 2015: 51 · 2014: 46 · 2013: 43 · 2012: 10
FWCI: 5.00
Type: journal article
Language: en
Open access: closed
Locations: JNCI Journal of the National Cancer Institute (publishedVersion)
PubMed (publishedVersion)
HighWire Press Open Archive (submittedVersion)
Funders: Breast Cancer Research Foundation
Jonsson Comprehensive Cancer Center
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 › Public Health, Environmental and Occupational Health › Women's cancer prevention and management
Keywords: breast cancer survivors, young women, health-related quality of life, fertility concerns, premature menopause, menopausal symptoms, infertility, depression, anxiety, weight gain, physical inactivity, psychosocial distress, cancer treatment side effects
MeSH terms: Adult, Age Factors, Anxiety, Breast Neoplasms, Depression, Female, Fertility, Humans, Menopause, Premature, Motor Activity, Quality of Life, Risk Factors, Stress, Psychological, United States, Weight Gain, Health Behavior, Exercise, Age Distribution, Survivors

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Quality of Life, Fertility Concerns, and Behavioral Health Outcomes in Younger Breast Cancer Survivors: A Systematic Review

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