Supplementary Material for: The Mode of Detection Is Not Associated with Quality of Life in Women with Breast Cancer

Introduction: Apart from saving lives, mammography screening programs (MSP) are expected to reduce negative side effects of treatment by detecting cancer earlier, when it is more responsive to less aggressive treatment. This study compared quality of life (QoL) among women with breast cancers that were detected either by screening mammography, as interval cancers, or clinically among women not participating in the MSP. Methods: Retrospective study of first-ever invasive breast cancers detected among MSP-eligible women aged 50–69 years between 2006 and 2012 in Münster, Germany. EORTC QLQ-C30 and -BR23 questionnaires were mailed to 1,399 cases still alive in 2015 (response rate 64.1%). Results: Women’s responses were obtained on average 6.1 years after diagnosis. Mean crude and age-adjusted scores for overall QoL, breast and body image (BBI), and five functional scales (FS) were comparable between groups of detection mode. Clearly lower adjusted means for most scores were observed in women with interval cancers, if time since diagnosis was less than 5 years. Cases younger than 60 years showed lower values for some FS, particularly among interval and screen-detected cases. Discussion/Conclusion: In summary, cases with breast cancer showed health-related score values that were similar to the general population of the same age. There was also no indication that mode of detection markedly influenced these scores. However, after adjusting for tumor stage and other influential factors, screening participants appeared more susceptible to score declines after a diagnosis of cancer than non-participants.

引言：乳腺钼靶筛查项目（mammography screening programs, MSP）除挽救生命外，还可通过更早检出癌症以降低治疗的负面副作用——此时癌症对低侵袭性治疗的响应性更佳。本研究对比了三类乳腺癌女性患者的生活质量（quality of life, QoL）：分别经乳腺钼靶筛查检出的乳腺癌、间隔期乳腺癌（interval cancers），以及未参与MSP的女性中临床检出的乳腺癌。

方法：本研究为回顾性研究，对象为2006至2012年间德国明斯特地区50~69岁符合MSP筛查条件的女性中确诊的首次浸润性乳腺癌患者。研究团队于2015年向1399名仍在世的患者邮寄了欧洲癌症研究与治疗组织（European Organisation for Research and Treatment of Cancer, EORTC）QLQ-C30及QLQ-BR23问卷，最终应答率为64.1%。

结果：研究平均在患者确诊后6.1年获得应答数据。不同检测方式组间的总体生活质量、乳腺与躯体意象（breast and body image, BBI）及五项功能量表（functional scales, FS）的粗得分与年龄校正得分均相近。若确诊后时长不足5年，间隔期乳腺癌患者的多数得分校正均值显著更低。年龄小于60岁的患者部分功能量表得分更低，尤以间隔期乳腺癌与筛查检出的乳腺癌患者群体为甚。

讨论与结论：综上，乳腺癌患者的健康相关得分与同年龄普通人群相近，未发现检测方式对上述得分存在显著影响。但在校正肿瘤分期及其他影响因素后，筛查参与者相较于未参与者，似乎更易在确诊后出现得分下降。