Evaluation of Long-Term Quality of Life, Anxiety, Depression, and Hope Among Iranian Breast Cancer Survivors: A Prospective, Multicenter, 5-Year Longitudinal Study; [ارزیابی کیفیت زندگی، اضطراب، افسردگی و امید در بهبود یافتگان سرطان پستان، یک مطالعه طولی 5 سال ه] Publisher



Sajadian A ; Shishavan N G ; Lahiji M R ; Heydari L ; Anbiaee R ; Omranipour R ; Nafissi N ; Alaeddini F
Source: Iranian Journal of Breast Diseases Published:2026

Abstract

Introduction: Given the high prevalence and increasing survival rates of breast cancer in recent years, evaluating quality of life (QoL) in this population has become of growing importance. The objective of this study was to assess the quality of life, as well as depression, anxiety, and hope in breast cancer survivors (BCS). Methods: A 5-year longitudinal prospective study was conducted among eligible breast cancer survivors referred to one of five referral medical centers in Tehran, Iran. Quality of life (SF-36), anxiety and depression (HADS), and hope (AHS) questionnaires at three time points (immediately, one year, and five years after treatment) were completed. Results: Of the 1250 recruited patients, 1,115 BCS participated in the study, and finally 856 women (76.7%) remained in the study for five years. Improvements were observed in all SF-36 subscales, including the physical (PCS) and mental component summaries (MCS) (P<0.001). Mixed model analysis showed that anxiety was inversely associated with PCS (β=-0.35, P=0.01) and MCS (β=-0.29, P=0.01). An older age at diagnosis was associated with reduced physical functioning (β = -0.12, P < 0.001). Contrary to this, both hope (β=0.021, β=0.45, P<0.001, respectively for PCS and MCS) and higher education demonstrated positive associations with QoL (β=3.75, β=2.20, P<0.0, respectively for PCS and MCS). Depression, marital status, occupation, and disease stage had no significant effect on PCS and MCS. Conclusion: The results demonstrated an improvement in quality of life among breast cancer survivors over five years. Anxiety and hope have been found to influence quality of life, underscoring the essential need for continuous attention to overall mental and physical health and regular psychosocial screening programs and hope-enhancing interventions, particularly in the first years following treatment. © 2026 Sajadian et al. Published by Breast Cancer Recearch Center, ACECR