Although women can expect to have normal physical and emotional well-being five or more years after breast cancer treatment, their quality of life may not be as good if they took tamoxifen or had chemotherapy.

In a study in the Journal of the National Cancer Institute (Vol. 94, No. 1: 39-49), Patricia Ganz, MD, a professor at the University of California, Los Angeles, and her colleagues looked at the quality of life of more than 800 breast cancer survivors. All were cancer-free and had their treatment at least five years before the survey.

Treatment for breast cancer did not, in general, reduce the quality of the women’s lives. The study looked at many different aspects of their lives, including physical function, mental and emotional health, energy, general health, and sexuality. All these turned out to be the same as expected in women who never had cancer.

But there was a group of women who were functioning less well than the entire group. These were the women who received adjuvant therapy either with tamoxifen or chemotherapy. They experienced slightly reduced physical functioning, but their energy levels, and emotional and mental health, were fine.

The group that seemed to have the most trouble included women who received chemotherapy after their breast cancer surgery. In particular they reported poorer sexual function. It wasn’t clear why this occurred.

One important finding was that the kind of surgery the women had made no difference. Whether they had lumpectomy or mastectomy, the quality of life was the same.

Breast cancer had a very positive impact on some of these women. Many of the survivors said they exercised more and ate healthier diets. A significant number experienced a greater interest in their career and work. Social life and family life also benefited. Another major change was increased spirituality and deepened religious beliefs.

Finances and love life were victims of breast cancer in some cases. Having breast cancer cut into the finances of a small percentage of women. It also affected the love life of almost one-third of the women.

Ganz and her colleagues said that overall the breast cancer survivors were doing well. “Long-term disease-free survivors of breast cancer have an excellent quality of life many years after their diagnosis,” they concluded.

But they were concerned about the long-term effects of adjuvant therapy, particularly chemotherapy. They counseled that this information should be taken into account when the doctor and patient are deciding on adjuvant therapy after surgery.