Backgrounds: Breast cancer is the most frequent cancer affecting women worldwide and the second most common cancer among Korean women; nevertheless, the survival rate of patients with breast cancer has continuously increased. This improvement in survival rate of breast cancer indicates the significance of healthcare for better prognosis and quality of life. We aimed to determine the association between adherence to American Cancer Society (ACS) guidelines for cancer survivors and health-related quality of life (HRQoL) among Korean breast cancer survivors.

Methods: We included a total of 302 breast cancer survivors (aged 54.18±9.11 years) who had been diagnosed with stage I to III primary breast cancer according to the American Joint Committee on Cancer (AJCC) and had breast cancer surgery at least 6 months before enrollment. We collected dietary information using food frequency questionnaire (FFQ) and other lifestyle factors using a structured questionnaire. We obtained clinical information from medical records at each hospital. We assessed HRQoL levels using the 36-Item Short Form Health Survey (SF-36). We calculated adherence scores based on “Nutrition and Physical Activity Guidelines for Cancer Survivors” released by the ACS: (1) achieving and maintaining a healthy body weight; (2) engaging in regular physical activity; and (3) following the ACS guidelines for cancer prevention; achieving a dietary pattern that is high in vegetables, fruits, and whole grains and low in processed and red meat. We examined the least square means (LS-means) and 95% confidence intervals (CIs) of HRQoL according to the quintiles of adherence scores using the generalized linear models (GLM).

Results: The adherence scores ranged from three to 12. We observed that increasing adherence scores were associated with increasing levels of physical functioning (PF) and vitality (VT) in all breast cancer survivors of our study; LS-means (95% CIs) of the lowest and the highest quintiles of adherence scores were 69.61 (63.92-75.30) and 78.35 (72.02-84.67), respectively (p for trend=0.04) for PF and 55.97 (49.65-62.30) and 64.23 (57.19-71.26), respectively (p for trend=0.05) for VT. Among participants with stage II or III, we found that high adherence to ACS guidelines was related to higher levels of HRQoL components of each physical component summary (PCS) and mental component summary (MCS). However, we did not observe positive associations among participants with stage I.

Conclusions: Increasing adherence to ACS guidelines was associated with increasing levels of physical functioning and vitality of HRQoL among Korean breast cancer survivors. Positive associations between adherence scores and HRQoL levels were limited to breast cancer survivors with stage II or III. Further prospective studies are needed to evaluate a temporal relationship between adherence to guidelines and HRQoL levels.

Citation Format: Dahye Koh, Sihan Song, Sang-Eun Moon, Jihyoung Cho, Young Bum Yoo, Se Kyung Lee, Jung Eun Lee. Adherence to guidelines for cancer survivors and health-related quality of life among Korean breast cancer survivors [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 5061.