Network analysis of quality of life in older breast cancer patients: A cross-sectional research from China

Abstract Objective The balance between treatment effectiveness and quality of life in elderly breast cancer patients is an important issue for clinicians to consider. The purpose of this study was to investigate the quality of life of elderly breast cancer patients and to explore the most critical factors affecting the quality of life. Methods This prospective cross-sectional study was conducted in the Cancer Hospital of the Chinese Academy of Medical Sciences from June 2022 to November 2022. Frailty Screening Scale and the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 were assessed among breast cancer patients aged ≥65 years. Network analysis was used to identify the core symptoms in the network. Results 481 patients who met inclusion criteria were included in the final analysis. Patients were divided into early (stage I-III) and advanced (stage IV) stage groups based on AJCC Version 8. Patients with advanced disease had a higher incidence of frailty than those with early disease (29.5% vs 11.4%, P<0.001). The quality of life of the former was generally lower than the latter group (P < 0.05 for all three functional areas, seven single symptoms, and economic aspects). Network analysis showed that in both early and advanced stage patients, "fatigue" was the most important symptom in the network and was closely related to patients' social function, role function and physical function. It is also most directly related to global health/quality of life (gQoL). Conclusion There is a general decline in quality of life in older women with advanced breast cancer. Fatigue is the most prominent problem that affects the quality of life. Related interventions need to be considered when developing clinical care plans for these patients.