Abstract
INTRODUCTION: Chemotherapy can cause sleep disorders, anxiety, depression, and decreased quality of life (QoL). This study aimed to compare sleep, anxiety, depression, and QoL during chemotherapy in patients with breast cancer to provide appropriate treatment at the appropriate time. METHODS: This prospective study included patients with breast cancer who received chemotherapy at Pusan National University Yangsan Hospital. We used three self-reporting questionnaires regarding quality of sleep (QoS), anxiety, depression, and QoL. QoL was measured using the Pittsburgh Sleep Quality Index, anxiety using the Beck Anxiety Inventory, depression using the Beck Depression Inventory, and QoL using the Quality of Life Enjoyment and Satisfaction Questionnaire-Short Form. Patients were assessed before, after, and during chemotherapy. RESULTS: In total, 55 patients were enrolled in this study, of whom 49 completed three self-reporting questionnaires. Anxiety, depression, QoS, and QoL varied during the study. Anxiety, depression, and QoL scores were lowest at the end of chemotherapy (p < 0.005). However, QoS scores were lowest at the beginning of chemotherapy (p < 0.005). Cancer subtype (triple-negative vs. luminal type), T stage, type of breast surgery (breast-conserving surgery vs. mastectomy), and chemotherapy type (adjuvant vs. neoadjuvant) did not show a relationship with QoL, anxiety, depression, or QoS; however, age exhibited differences in all four areas. Patients aged >50 years experienced more sleep disturbances, anxiety, depression, and a decreased QoL. In addition, anxiety was increased during chemotherapy in patients with lymph node metastasis. CONCLUSIONS: Patients with breast cancer experience sleep disturbances, anxiety, depression, and low QoL during chemotherapy. During chemotherapy, these symptoms are often overlooked owing to the side effects of chemotherapy. Proper treatment and emotional support will help patients improve their QoL, anxiety, depression, and QoL.