Abstract PS1-02-30: Beyond breast cancer survival: quality of life aspects in women undergoing endocrine therapy

Abstract Background: Endocrine therapy (ET) is the cornerstone of hormone-receptor positive (HR+) breast cancer treatment. However, it is potentially associated with several adverse events, which can impact patients' quality of life (QoL). Depicting different spheres of QoL affected by ET is essential to improve supportive care strategies. This study aimed to evaluate QoL among breast cancer patients on mid/long-term ET, exploring its diverse domains. Methods: Single-center, observational cohort study. Female patients with HR+ breast cancer undergoing systemic ET for at least 6 months were included. Participants fulfilled a unique online questionnaire, including the validated European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) + Breast Cancer-specific Module (BR23). QoL was assessed across several functioning and symptom domains. Each score domain was transformed into a score ranging 0 to 100, according to EORTC guidelines. Higher scores indicated a better quality of life for functioning domains/general health status, and a greater symptom burden. Descriptive statistics were used to characterize the domains (mean scores) and the population characteristics. Correlations between the patient’s characteristics and the scores were evaluated with Student’s T test. Results: 200 patients, with a median age of 44 years-old (range: 27-92), were included. The majority had at least higher education (87%), were self-declared as white (69%; brown/black: 24.5%), heterosexual (95.5%), were premenopausal (74.5%), overweight (68%) and had children (69.5%). 14% were under ET for metastatic disease (86% adjuvant ET), 94.5% had primary breast cancer surgery (50.5% conservative) and 49% breast reconstructive surgery. Chemotherapy was used in 62.5% and the ongoing ETs were: SERMs (22.5%), aromatase inhibitors (70.5%) and SERDs (7%); 58.5% associated with ovarian function suppression. Global health status (71.4) and physical and role functioning (76.9 and 71.8) were relatively well preserved in this cohort. Financial difficulties (25.7), and symptoms related to surgery, such as breast (23.3) and arm (31.9) pain were also not impactful. However, patients had significant impairment in sexual functioning (27.4), future perspective (27.5), body image (56.6) and in emotional (51.3) and cognitive (52.9) functioning. Insomnia (52.0) and fatigue (40.1) were the most impactful symptoms. Premenopausal status was correlated to worse body image (52.9 vs 67.1; p=0.014) and emotional functioning (49.4 vs 56.9; p=0.006). There was a trend for worse body image in patients who underwent breast reconstructive surgery (46.9 vs 66.5; p=0.055), worse sexual functioning for aromatase inhibitors versus SERMs (25.9 vs 32.6; p=0.059) and worse global health status in premenopausal women (70.1 vs 75.2; p=0.058). Conclusion: This study highlights the impact of ET and breast cancer diagnosis in the sexual, cognitive and emotional functioning, as well in the future perspective and body image of HR+ breast cancer patients. Premenopausal women appear to be the most affected. These insights underscore the importance of routine QoL assessment in clinical practice, and the urgent need for improvement in survivorship care for breast cancer patients. Citation Format: M. C. Carvalho, I. d. Oliveira, B. C. Figueroa, T. C. Lima, R. P. Souza, S. M. Sanches, V. C. Lima, M. G. Cesca. Beyond breast cancer survival: quality of life aspects in women undergoing endocrine therapy abstract. In: Proceedings of the San Antonio Breast Cancer Symposium 2025; 2025 Dec 9-12; San Antonio, TX. Philadelphia (PA): AACR; Clin Cancer Res 2026;32(4 Suppl):Abstract nr PS1-02-30.