Quality of Life in Women Diagnosed with Breast Cancer after a 12-Month Treatment of Lifestyle Modifications

Concetta Montagnese, Giuseppe Porciello, Sara Vitale, Elvira Palumbo, Anna Crispo, Maria Grimaldi, Ilaria Calabrese, Rosa Pica, Melania Prete, Luca Falzone, Massimo Libra, Serena Cubisino, Luigina Poletto, Valentina Martinuzzo, Sergio Coluccia, Nadia Esindi, Flavia Nocerino, Anita Minopoli, Bruna Grilli, Pasqualina C FiorilloMarco Cuomo, Ernesta Cavalcanti, Guglielmo Thomas, Daniela Cianniello, Monica Pinto, Michelino De Laurentiis, Carmen Pacilio, Massimo Rinaldo, Massimiliano D'Aiuto, Diego Serraino, Samuele Massarut, Laura Caggiari, Chiara Evangelista, Agostino Steffan, Francesca Catalano, Giuseppe L Banna, Giuseppa Scandurra, Francesco Ferraù, Rosalba Rossello, Giovanna Antonelli, Gennaro Guerra, Amalia Farina, Francesco Messina, Gabriele Riccardi, Davide Gatti, David J A Jenkins, Egidio Celentano, Gerardo Botti, Livia S A Augustin

Research output: Contribution to journalArticlepeer-review


Healthy lifestyles are associated with better health-related quality of life (HRQoL), favorable prognosis and lower mortality in breast cancer (BC) survivors. We investigated changes in HRQoL after a 12-month lifestyle modification program in 227 BC survivors participating in DEDiCa trial (Mediterranean diet, exercise, vitamin D). HRQoL was evaluated through validated questionnaires: EQ-5D-3L, EORTC-QLQ-C30 and EORTC QLQ-BR23. Baseline changes were tested using analysis of variance. Multiple regression analyses were performed to assess treatment effects on HRQoL. Increases were observed in global health status (p < 0.001), physical (p = 0.003), role (p = 0.002) and social functioning (p < 0.001), body image (p < 0.001), future perspective (p < 0.001), well-being (p = 0.001), and reductions in fatigue (p < 0.001), nausea and vomiting (p = 0.015), dyspnea (p = 0.001), constipation (p = 0.049), financial problems (p = 0.012), sexual functioning (p = 0.025), systematic therapy side effects (p < 0.001) and breast symptoms (p = 0.004). Multiple regression analyses found inverse associations between changes in BMI and global health status (p = 0.048) and between serum 25(OH)D levels and breast symptoms (p = 0.002). A healthy lifestyle treatment of traditional Mediterranean diet and exercise may impact positively on HRQoL in BC survivors possibly through reductions in body weight while vitamin D sufficiency may improve BC-related symptoms. These findings are relevant to BC survivors whose lower HRQoL negatively affects treatment compliance and disease outcomes.

Original languageEnglish
Issue number1
Publication statusPublished - 2021


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