544. Associations between mental health–related factors and quality of life in patients with breast cancer: a cross-sectional tudy

Abstract

Abstract Background Breast cancer is one of the most prevalent malignancies among women worldwide, and advances in early detection and treatment have substantially improved survival rates. Consequently, quality of life has emerged as a critical outcome in breast cancer care. Beyond the physical burden of cancer and its treatment, patients frequently experience psychiatric problems, including anxiety, depression, sleep disturbances, and elevated perceived stress. In addition, social support and health-related behaviors, such as alcohol use, may further influence overall well-being. Despite increasing recognition of these factors, few studies have comprehensively examined the relative contributions of multiple mental health–related variables to quality of life in patients with breast cancer. Aims & Objectives The primary aim of this study was to investigate the associations between mental health–related factors and quality of life among patients with breast cancer. Specifically, this study sought to identify psychological, behavioral, and social factors independently associated with quality of life after adjusting for relevant clinical and sociodemographic variables. Method This cross-sectional study included 323 patients attending a breast cancer clinic. Mental health status was assessed using validated self-report instruments: the Hospital Anxiety and Depression Scale (HADS) for anxiety and depressive symptoms; the Pittsburgh Sleep Quality Index (PSQI) for sleep quality; the Alcohol Use Disorders Identification Test (AUDIT) for problematic alcohol use; the Perceived Stress Scale (PSS) for perceived stress; and the Multidimensional Scale of Perceived Social Support (MSPSS) for perceived social support. Quality of life was evaluated using the World Health Organization Quality of Life–Brief Version (WHOQOL-BREF). Univariate regression analyses were conducted to examine associations between individual variables and quality of life. Variables showing potential associations, together with clinically relevant covariates, were subsequently entered into a multivariate regression model using backward elimination to identify independent predictors. Results Univariate regression analyses showed that HADS anxiety (p < 0.001), HADS depression (p < 0.001), PSQI (p < 0.001), PSS (p < 0.001) and MSPSS (p < 0.001) scores were significantly associated with quality of life, whereas alcohol use, as measured by the AUDIT, was not. In the multivariate regression model, depressive symptoms (p < 0.001), perceived stress (p < 0.001), and perceived social support (p < 0.001) remained independently associated with quality of life after adjustment for other variables. Discussion & Conclusions This study demonstrates that key mental health–related factors are independently associated with quality of life in patients with breast cancer. Higher levels of depressive symptoms and perceived stress, as well as lower levels of social support, were associated with poorer quality of life, even after controlling for clinical and sociodemographic characteristics. These findings underscore the importance of routine mental health screening and comprehensive psychosocial interventions as integral components of breast cancer care. Targeted strategies addressing psychological distress and enhancing social support may contribute to meaningful improvements in quality of life among patients with breast cancer.