The impact of chronic comorbidities at the time of breast cancer diagnosis on quality of life, and emotional health following treatment in Canada

Advances in breast cancer screening and treatment have led to an increasing number of breast cancer survivors. The objective of this study was to determine the impact of comorbidities on self-reported quality of life (QOL) and emotional health following a breast cancer diagnosis and treatment. Women with a personal history of breast cancer (N = 3,372) were identified from the cross-sectional Canadian Partnership Against Cancer (CPAC) Experiences of Cancer Patients in Transitions Survey. Multinomial (nominal) logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (CI) for the relationship between burden of comorbidities and overall QOL and emotional health (very poor/poor, fair, good, very good). Of the 3,372 participants, 57% reported at least one chronic condition at the time of breast cancer diagnosis. As the number of chronic conditions at diagnosis increased, the odds of reporting worse quality of life and emotional health following treatment also increased. Specifically, compared to women reporting very good QOL, for each additional chronic condition, women reported significantly higher odds of reporting good (OR = 1.22, 95% CI: 1.12, 1.32), fair (OR = 1.76, 95% CI: 1.58, 1.96), or poor/very poor (OR = 2.31, 95% CI: 1.86, 2.88) QOL. Similarly, for each additional comorbidity, women reported significantly higher odds of reporting good (OR = 1.17, 95% CI: 1.07, 1.28), fair (OR = 1.63, 95% CI: 1.46, 1.82), or poor/very poor (OR = 2.17, 95% CI: 1.81, 2.60) emotional health, relative to very good emotional health. Breast cancer survivors coping with a high comorbidity burden experience worse overall QOL and emotional health following treatment. This highlights the importance of integrating information on comorbidities into survivorship care to improve the experience and overall outcomes of patients with complex needs.