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    Awarded Grants
    Quality of Life Before and After a Breast Cancer Diagnosis in Older Women

    Scientific Abstract:
    Title: Quality of Life Before and After a Breast Cancer Diagnosis in Older Women. Background: As more women are surviving breast cancer longer, health issues important to survivors in addition to breast cancer treatment and surveillance need to be addressed. While the quality of life of breast cancer survivors has been explored in many clinical trial settings, the quality of life of population samples of survivors relative to their quality of life prior to diagnosis has not been described. Objective/Hypothesis: We propose to characterize the relation between quality of life and other major health events in relation to breast cancer morbidity and mortality. In particular, we hypothesize that quality of life prior to diagnosis of breast cancer predicts quality of life after diagnosis, that the impact on quality of life of non-cancer-related health events in breast cancer survivors depends on their quality of life prior to diagnosis, that long-term breast cancer survivors have similar quality of life as women without breast cancer controlling for co-morbidities, and that poor quality of life is a risk factor for breast cancer. Specific Aims: We aim to address these questions to identify women at greatest risk of poor quality of life in the short and long term after a breast cancer diagnosis. Study Design: In this project, we plan to utilize data from the Beaver Dam Studies Cohort of 2,762 women enrolled in 1988-1990 and aged 43-86 years at baseline. Women have been re-contacted as many as six additional times for on-going follow-up. Cohort participants have completed lengthy standardized interviews that include quality of life measures as well as information regarding breast cancer risk factors and co-morbid conditions. Diagnoses of breast cancer will be ascertained through linkage with Wisconsin’s tumor registry (estimated N=190). Analyses will permit quality of life comparisons between breast cancer survivors (before and after diagnosis) and women without a personal history of breast cancer. Potential Outcomes and Benefits: Our project will provide a rare opportunity to prospectively observe changes in quality of life in women with a breast cancer diagnosis as they are diagnosed, age, and experience other health events such as menopause or cardiovascular disease. By improving our understanding of the complex interplay between the mental and physical health of breast cancer survivors, we may take steps to optimize their length and quality of life.

    Lay Abstract:
    Title: Quality of Life Before and After a Breast Cancer Diagnosis in Older Women. With the success of early detection through mammography and more effective treatment options, increasing numbers of women faced with a breast cancer diagnosis are living longer. For this reason, issues of quality of life—not just length of survival—are receiving greater attention from researchers, clinicians, and survivors. Breast cancer clearly impacts quality of life, yet few opportunities have existed to observe how quality of life changes as women age, experience breast cancer diagnosis and treatment, and deal with other challenges to their health such as heart disease and diabetes. We propose to characterize the relation between quality of life and other major health events in relation to breast cancer morbidity and mortality. In particular, we hypothesize that quality of life prior to diagnosis of breast cancer predicts quality of life after diagnosis, that the impact on quality of life of non-cancer-related health events in breast cancer survivors depends on their quality of life prior to diagnosis, that long-term breast cancer survivors have similar quality of life as women without breast cancer controlling for co-morbidities, and that poor quality of life is a risk factor for breast cancer. We propose to link data available from a cohort of older Wisconsin women with data collected by Wisconsin’s statewide tumor registry. Over 2,700 participating women were aged 43-86 years in 1988-90 and have been re-contacted for participation as many as six additional times since the baseline enrollment; data collection is currently on-going. Women have completed interviews along with physical examinations to evaluate quality of life, breast cancer risk factors, and many other health indicators. We estimate that almost 200 women will have experienced a breast cancer diagnosis before 2005, approximately half before the baseline examination and half of them since the baseline examination in 1988-90. Statistical analysis will allow quality of life comparisons between breast cancer survivors (before and after diagnosis) and women without a personal history of breast cancer. Our project will provide a rare opportunity to observe, prospectively, changes in quality of life in women experiencing a breast cancer diagnosis and, often, other health problems. By improving our understanding of the complex interplay between the mental and physical health of breast cancer survivors, we may take steps to optimize their length and quality of life.