Health-related quality of life in different stages of breast cancer in Serbia.

Objective: Breast cancer is the most commonly diagnosed malignant tumor worldwide, and Serbia ranks first in Europe in standardized breast cancer mortality rate. The aim of this research is to estimate health-related quality of life (HRQoL) and work productivity among patients in different stages of breast cancer in Serbia.

Subjects and methods: A total of 175 breast cancer patients attending the breast cancer outpatient clinic at the Oncology Institute of Vojvodina between March 2022 and February 2023 were included in the study. Patients were divided into three mutually exclusive groups: (1) First year after primary breast cancer (Group P), (2) Second and following years after primary breast cancer or recurrence (Group S) and (3) Metastatic disease (Group M). The EQ-5D-3L self-classifier was used to estimate the HRQoL, using the EQ-5D-3L index value and visual analog scale (VAS) score.

Results: Мean EQ-5D-3L index value was 0.777 for Group P, and 0.768 for Group S. Patients with metastatic disease reported the lowest EQ-5D index value of 0.646 (p < 0.05). Pain/discomfort, as well as anxiety/depression, were the main drivers of the reduction in HRQoL. Patients in Group M also reported the lowest VAS score of 65.4. Furthermore, the highest percentage of women who sought leave or cited breast cancer as the reason for their early retirement were patients with metastatic disease.

Conclusions: HRQoL was most impaired in Group M, and patients with metastatic disease were more likely to take sick leave or retire early due to breast cancer. Delaying or preventing metastatic recurrence could significantly benefit patients' productivity and HRQoL.