Global Perspective
Breast cancer has been ranked fifth as the most common cause of mortality with nearly 1.7 million new cases diagnosed in 2012 worldwide (Ferlay et al., 2012). The mean prevalence of breast cancer is about 66.7 cases per 100 000 women (ACS, 2009). In many countries with cutting edge therapeutic care the 5-year survival rate of early diagnosed breast cancer is 80-90% which might get reduced to 24% in case of late diagnosis, resulting in more focus on possible treatment and quality of life of breast cancer patients (Ferlay et al., 2012). Health related quality of life is a subjective and multidimensional concept that is made out of expansive areas, by and large including physical, social, emotional, and functional well-being as well as symptoms from breast cancer disease and its treatment. The major issues effecting patient’s quality of life includes mental and emotional effects of illness, diagnostic and therapeutic measures, stress, pain, depression, disease outcomes on family, marital and social relations, additional economic burdens, nutritional issues and treatment complications (Shakeri et al., 2009). One of the most widely used tool for measuring HRQoL among cancer patients is European organization for research and treatment of cancer quality of life (EORTC QLQ-C30) questionnaire which is specifically design to measure four key domains of patients namely physical functioning, emotional functioning, fatigue and pain. EORTC QLQ-C30 questionnaire (English Version) is reliable and valid instrument to determine health related quality of life among breast cancer patients (Luo et al., 2005). A study from Netherlands confirmed the importance and benefits of using EORTC QLQ-C30 questionnaire in identifying patients with clinically important problems which could be later intervened by health care professionals (Giesinger et al., 2016).
National Perspective
Breast cancer has been considered as an emerging non-communicable threat in Pakistan. One out of every nine women is most likely at the risk to suffer from breast cancer at any stage of their life mainly due to lack of access to screening facilities & specialty hospitals. Poor socio-economic status, lower educational background, socially stigmatized situation and paucity of early detection programs are also responsible for adding towards cancer burden in Pakistan. Most of the breast cancer patients experience depression. Limited access to health care facilities, less number of qualified oncologists, lack of technical equipment for diagnosis are the major factors effecting adequate control and prevention of breast cancer in Pakistan. The importance of health-related quality of life and its determinants including physical, emotional and functional domains among breast cancer women has long been recognized in developed world but in developing countries including Pakistan, this concept is still in infancy, although its rate has been increasing at an alarming rate in Pakistan. Limited studies have assessed health related quality of life among breast cancer patients in Pakistan. A study from Pakistan reported that breast cancer patients had poor HRQoL in spite of self-examination awareness campaigns and advanced therapeutic strategies. Breast cancer had a negative impact on health-related quality of life across all domains in Pakistan. Highest scores were observed in domains of fatigue and financial difficulties whereas, lowest scores for HRQoL were observed in the domain of symptom scale followed by domain of emotional functioning. On the other side, in view of caregivers the highest scores perceived were observed in dyspnoea followed by pain.