Clinical Variables Associated with Quality of Life Among Women with Breast Cancer: A Cross-Sectional Study
DOI:
https://doi.org/10.55018/janh.v8i2.615Keywords:
Breast Neoplasms, Quality of Life, Clinical Characteristics, EORTC QLQ-C30, IndonesiaAbstract
Background: Breast cancer is a major public health concern in Indonesia. Clinical factors such as disease duration, cancer stage, treatment type, and comorbidities may affect patients’ quality of life (QoL), but evidence in Indonesia remains limited. This study aimed to examine the correlation between clinical variables and QoL among breast cancer patients.
Methods: This cross-sectional study was conducted between November 2025 and January 2026 at a referral hospital in West Java, Indonesia, and followed the STROBE guidelines. A total of 53 breast cancer patients were recruited using convenience sampling. The independent variables included clinical characteristics such as duration of illness, cancer stage, treatment received, treatment frequency, comorbidities, body mass index (BMI), and family history of cancer, while the dependent variable was QoL. QoL was assessed using the Indonesian version of the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30), a validated instrument for evaluating functional status, symptoms, and global health status among cancer patients. QoL is categorised into poor, moderate, and good. Bivariate analysis was performed using Fisher’s exact test and the chi-square test.
Results: Among the 53 breast cancer patients, the majority had been diagnosed for less than one year (45.3%), underwent surgery combined with chemotherapy (41.5%), and received treatment every three weeks (64.2%). Most patients reported moderate global health status (49.1%), while 35.8% had poor QoL. Significant associations were found between duration of illness (p < .001; Cramer’s V = 0.467), treatment received (p = .030; Cramer’s V = 0.434), and treatment frequency (p = .034; Cramer’s V = 0.396) and global health status. No significant associations were identified between cancer stage, comorbidities, BMI category, or family history of cancer and QoL.
Conclusion: Duration of illness and treatment-related factors were significantly associated with quality of life among breast cancer patients. These findings suggest that the illness trajectory and treatment burden may be substantially related to patients’ overall well-being, supporting the need for targeted supportive care and routine QoL monitoring to improve patient-centred outcomes.
Downloads
References
Aaronson, N. K., Ahmedzai, S., Bergman, B., Bullinger, M., Cull, A., Duez, N. J., Filiberti, A., Flechtner, H., Fleishman, S. B., & Haes, J. C. J. M. de. (1993). The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. JNCI: Journal of the National Cancer Institute, 85(5), 365–376.
Al Qadire, M., Alsaraireh, M., Alomari, K., Aldiabat, K. M., Al-Sabei, S., Al-Rawajfah, O., & Aljezawi, M. (2021). Symptom Clusters Predictive of Quality of Life Among Jordanian Women with Breast Cancer. Seminars in Oncology Nursing, 37(2), 151144. https://doi.org/10.1016/j.soncn.2021.151144
Aljadani, F., Nughays, R., Alharbi, G., Almazroy, E., Elyas, S., Danish, H., Alanazi, R., Aldrees, B., Jadkarim, G., & Mikwar, Z. (2025). Quality of Life in Breast Cancer Patients in Saudi Arabia: A Systematic Review. Breast Cancer : Targets and Therapy, 17, 171–186. https://doi.org/10.2147/bctt.s505725
Anggraeni, F. D., Sukartini, T., & Nihayati, H. E. (2023). Quality of life of breast cancer patients. Pediomaternal Nursing Journal, 9(1), 31–35. https://doi.org/10.20473/pmnj.v9i1.42249
Biparva, A. J., Raoofi, S., Rafiei, S., Kan, F. P., Kazerooni, M., Bagheribayati, F., Masoumi, M., Doustmehraban, M., Sanaei, M., Zarabi, F., Raoofi, N., Chomalu, Z. B., Ahmadi, B., Talab, F. S., Hoseini, B. S., Asadollahi, E., Mir, M., Deylami, S., Zareei, M., … Ghashghaee, A. (2022). Global quality of life in breast cancer: systematic review and meta-analysis. BMJ Supportive & Palliative Care, 13. https://doi.org/10.1136/bmjspcare-2022-003642
Brotobor, D., Nwozichi, C., & Brotobor, O. (2025). Symptom clusters in breast cancer patients, post-chemotherapy: Prevalence, severity, and network analysis approaches. Babcock University Medical Journal. https://doi.org/10.38029/babcockuniv.med.j..v8i1.727
Carreira, H., Williams, R., Dempsey, H., Stanway, S., Smeeth, L., & Bhaskaran, K. (2020). Quality of life and mental health in breast cancer survivors compared with non-cancer controls: a study of patient-reported outcomes in the United Kingdom. Journal of Cancer Survivorship, 15, 564–575. https://doi.org/10.1007/s11764-020-00950-3
Haddou, M. B., Igarramen, T., Khouchani, M., & Elkhoudri, N. (2024). Determinants of Health-related Quality of Life in Breast Cancer Patients: A Comprehensive Study in Marrakech, Morocco. The Open Public Health Journal. https://doi.org/10.2174/0118749445317154240729053442
Hamer, J., McDonald, R., Zhang, L., Verma, S., Leahey, A., Ecclestone, C., Bedard, G., Pulenzas, N., Bhatia, A., Chow, R., DeAngelis, C., Ellis, J., Rakovitch, E., Lee, J., & Chow, E. (2017). Quality of life (QOL) and symptom burden (SB) in patients with breast cancer. Supportive Care in Cancer, 25, 409–419. https://doi.org/10.1007/s00520-016-3417-6
Haroen, H., Pahria, T., Agustina, H. R., Nyarumentang, G., Winarno, A., Windani, C., Sari, M., Natasya, W., & Pardosi, J. F. (2026). Patient Navigation Needs and Quality of Life Among Women with Gynecological Cancer in Indonesia : A Cross-Sectional Study. Healthcare, 14(1388), 1–18.
Heidary, Z., Ghaemi, M., Rashidi, H., Gargari, O. K., & Montazeri, A. (2023). Quality of Life in Breast Cancer Patients: A Systematic Review of the Qualitative Studies. Cancer Control : Journal of the Moffitt Cancer Center, 30. https://doi.org/10.1177/10732748231168318
Hutajulu, S. H., Prabandari, Y. S., Bintoro, B. S., Wiranata, J. A., Widiastuti, M., Suryani, N. D., Saptari, R. G., Taroeno-Hariadi, K. W., Kurnianda, J., Purwanto, I., Hardianti, M. S., & Allsop, M. J. (2022). Delays in the presentation and diagnosis of women with breast cancer in Yogyakarta, Indonesia: A retrospective observational study. PLOS ONE, 17(1), e0262468. https://doi.org/10.1371/journal.pone.0262468
Icanervilia, A. V., Choridah, L., Van Asselt, A. D. I., Vervoort, J. P. M., Postma, M. J., Rengganis, A. A., & Kardinah, K. (2023). Early Detection of Breast Cancer in Indonesia: Barriers Identified in a Qualitative Study. Asian Pacific Journal of Cancer Prevention : APJCP, 24(8), 2749–2755. https://doi.org/10.31557/APJCP.2023.24.8.2749
Imran, M., Al-Wassia, R., Alkhayyat, S., Baig, M., & Al-Saati, B. A. (2019). Assessment of quality of life (QoL) in breast cancer patients by using EORTC QLQ-C30 and BR-23 questionnaires: A tertiary care center survey in the western region of Saudi Arabia. PLoS ONE, 14. https://doi.org/10.1371/journal.pone.0219093
International Agency for Research on Cancer. (2026). Absolute numbers, Incidence and Mortality, Females, in 2022 (Cancer in Indonesia). GLOBOCAN 2022: Indonesia Fact Sheet.
Karalienė, V., Petravičienė, Z., & Budrienė, L. (2025). Quality of Life in Patients With Breast Cancer: A Pilot Study. Reabilitacijos Mokslai: Slauga, Kineziterapija, Ergoterapija. https://doi.org/10.33607/rmske.v1i32.1595
Kementrian Kesehatan Republik Indonesia. (2024). Rencana kanker nasional 2024-2034 (Issue September).
Kim, J., Harper, A., McCormack, V., Sung, H., Houssami, N., Morgan, E., Mutebi, M., Garvey, G., Soerjomataram, I., & Fidler-Benaoudia, M. M. (2025). Global patterns and trends in breast cancer incidence and mortality across 185 countries. Nature Medicine. https://doi.org/10.1038/s41591-025-03502-3
Kurniawati, D., & Aryzki, S. (2023). Knowledge Of Early Detection Of Breast Cancer Using Bse Method In Pharmaceutical Students. International Student Conference of Global Multidisciplinary Collaboration, 1(1), 94–100.
Mokhatri-Hesari, P., & Montazeri, A. (2020). Health-related quality of life in breast cancer patients: review of reviews from 2008 to 2018. Health and Quality of Life Outcomes, 18. https://doi.org/10.1186/s12955-020-01591-x
Ngo, N., Nguyen, H., Nguyen, P. T. L., Vo, T. T. T., Phung, T., Pham, A. G., Vo, T., Dang, M. T. N., Bao, T. N. Le, & Duong, K. (2023). Health-related quality of life in breast cancer patients in low-and-middle-income countries in Asia: a systematic review. Frontiers in Global Women’s Health, 4. https://doi.org/10.3389/fgwh.2023.1180383
NICE. (2025). Early and locally advanced breast cancer : diagnosis and management (Issue July 2018).
Panggabean, R. T. A., Octavia, L., Dwi, N., & -, A. (2023). Early Detection of Breast Cancer Using the K-Nearest Neighbour (K-Nn) Algorithm. Jurnal Sistem Informasi Dan Ilmu Komputer Prima(JUSIKOM PRIMA), 6(2), 38–42. https://doi.org/10.34012/jurnalsisteminformasidanilmukomputer.v6i2.3194
Park, J., Rodriguez, J., O’Brien, K., Nichols, H., Hodgson, M., Weinberg, C., & Sandler, D. (2020). Health‐related quality of life outcomes among breast cancer survivors. Cancer, 127. https://doi.org/10.1002/cncr.33348
Peng, Y., Ma, J., Liu, L., Xiao, J., & Gu, C. (2026). Determinants of patient delay and its association with quality of life among young women with breast cancer in China: A cross-sectional study. Asia-Pacific Journal of Oncology Nursing, 13, 100846. https://doi.org/10.1016/j.apjon.2025.100846
Perwitasari, D. A., Atthobari, J., Dwiprahasto, I., Hakimi, M., Gelderblom, H., Putter, H., Nortier, J. W. R., Guchelaar, H. J., & Kaptein, A. A. (2011). Translation and validation of EORTC QLQ-C30 into Indonesian version for cancer patients in Indonesia. Japanese Journal of Clinical Oncology, 41(4), 519–529. https://doi.org/10.1093/jjco/hyq243
Rezanejad Gatabi, Z., Mirhoseini, M., Khajeali, N., Rezanezhad Gatabi, I., Dabbaghianamiri, M., & Dorri, S. (2022). The Accuracy of Electrical Impedance Tomography for Breast Cancer Detection: A Systematic Review and Meta-Analysis. The Breast Journal, 2022, 8565490. https://doi.org/10.1155/2022/8565490
Schmidt, M., Wiskemann, J., & Steindorf, K. (2018). Quality of life, problems, and needs of disease-free breast cancer survivors 5 years after diagnosis. Quality of Life Research, 27, 2077–2086. https://doi.org/10.1007/s11136-018-1866-8
So, W., Law, B., Ng, M., He, X., Chan, D., Chan, C., & McCarthy, A. (2021). Symptom clusters experienced by breast cancer patients at various treatment stages: A systematic review. Cancer Medicine, 10, 2531–2565. https://doi.org/10.1002/cam4.3794
Soto-Ruiz, N., Escalada-Hernández, P., Pimentel-Parra, G. A., & García-Vivar, C. (2025). Quality of life in long-term cancer-free breast cancer survivors in spain: A descriptive study. Scientific Reports, 15. https://doi.org/10.1038/s41598-025-10176-x
Suanjaya, M. A., Anulus, A., & Husodo, B. T. (2025). Determinan Kualitas Hidup Pasien Pasca Operasi Kanker Payudara di Indonesia: A Systematic review. Sehat Rakyat: Jurnal Kesehatan Masyarakat, 4(3), 685–697. https://doi.org/10.54259/sehatrakyat.v4i3.5476
Tang, J., Guo, B., Zhong, C., Chi, J., Fu, J., Lai, J., Zhang, Y., Guo, Z., Deng, S., & Wu, Y. (2025). Detection of differences in physical symptoms between depressed and undepressed patients with breast cancer: a study using K-medoids clustering. BMC Cancer, 25(1). https://doi.org/10.1186/s12885-024-13387-z
Wang, X., Wang, N., Zhong, L., Wang, S., Zheng, Y., Yang, B., Zhang, J., Lin, Y., & Wang, Z. (2020). Prognostic value of depression and anxiety on breast cancer recurrence and mortality: a systematic review and meta-analysis of 282,203 patients. Molecular Psychiatry, 25(12), 3186–3197. https://doi.org/10.1038/s41380-020-00865-6
Wilkinson, R., & Smith, L. (2024). Quality of Life in Female Breast Cancer Patients and Survivors in a South African Municipality. Breast Cancer : Basic and Clinical Research, 18. https://doi.org/10.1177/11782234241282519
World Health Organization. (2024). Breast cancer. https://www.who.int/news-room/fact-sheets/detail/breast-cancer
Xiao, M., Ji, L., Qian, X., Chen, X., Xiu, M., Li, Z., Cao, H., Chen, S.-S., Li, Q., Li, Q., Wang, X., Wang, J., Li, Y., Zheng, X., Zhang, J., & Zhang, P. (2025). Association of quality of life in older patients with breast cancer: a cross-sectional study from China. BMJ Open, 15. https://doi.org/10.1136/bmjopen-2024-085842
Zehra, S., Doyle, F., Barry, M., Walsh, S., & Kell, M. (2020). Health-related quality of life following breast reconstruction compared to total mastectomy and breast-conserving surgery among breast cancer survivors: a systematic review and meta-analysis. Breast Cancer, 27, 534–566. https://doi.org/10.1007/s12282-020-01076-1
Downloads
Additional Files
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Anastasia Anna, Yanny Trisyani , Aan Nuraeni, Ayu Prawesti Priambodo, Firman Sugiharto

This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.














