Quality of life in women diagnosed with breast cancer after a 12-month treatment of lifestyle modifications

C. Montagnese, G. Porciello, S. Vitale, E. Palumbo, A. Crispo, M. Grimaldi, I. Calabrese, R. Pica, M. Prete, L. Falzone, M. Libra, S. Cubisino, L. Poletto, V. Martinuzzo, S. Coluccia, N. Esindi, F. Nocerino, A. Minopoli, B. Grilli, P.C. FiorilloM. Cuomo, E. Cavalcanti, G. Thomas, D. Cianniello, M. Pinto, M. De Laurentiis, C. Pacilio, M. Rinaldo, M. D’aiuto, D. Serraino, S. Massarut, L. Caggiari, C. Evangelista, A. Steffan, F. Catalano, G.L. Banna, G. Scandurra, F. Ferraù, R. Rossello, G. Antonelli, G. Guerra, A. Farina, F. Messina, G. Riccardi, D. Gatti, D.J.A. Jenkins, E. Celentano, G. Botti, L.S.A. Augustin

Research output: Contribution to journalArticlepeer-review


Healthy lifestyles are associated with better health-related quality of life (HRQoL), favorable prognosis and lower mortality in breast cancer (BC) survivors. We investigated changes in HRQoL after a 12-month lifestyle modification program in 227 BC survivors participating in DEDiCa trial (Mediterranean diet, exercise, vitamin D). HRQoL was evaluated through validated questionnaires: EQ-5D-3L, EORTC-QLQ-C30 and EORTC QLQ-BR23. Baseline changes were tested using analysis of variance. Multiple regression analyses were performed to assess treatment effects on HRQoL. Increases were observed in global health status (p < 0.001), physical (p = 0.003), role (p = 0.002) and social functioning (p < 0.001), body image (p < 0.001), future perspective (p < 0.001), well-being (p = 0.001), and reductions in fatigue (p < 0.001), nausea and vomiting (p = 0.015), dyspnea (p = 0.001), consti-pation (p = 0.049), financial problems (p = 0.012), sexual functioning (p = 0.025), systematic therapy side effects (p < 0.001) and breast symptoms (p = 0.004). Multiple regression analyses found inverse associations between changes in BMI and global health status (p = 0.048) and between serum 25(OH)D levels and breast symptoms (p = 0.002). A healthy lifestyle treatment of traditional Mediterranean diet and exercise may impact positively on HRQoL in BC survivors possibly through reductions in body weight while vitamin D sufficiency may improve BC-related symptoms. These findings are relevant to BC survivors whose lower HRQoL negatively affects treatment compliance and disease outcomes. © 2020 by the authors. Licensee MDPI, Basel, Switzerland.
Original languageEnglish
Pages (from-to)1-15
Number of pages15
Issue number1
Publication statusPublished - 2021


  • Breast cancer
  • Lifestyle
  • Mediterranean diet
  • Physical activity
  • Quality of life
  • Vitamin D
  • 25 hydroxyvitamin D
  • vitamin D
  • adult
  • Article
  • body image
  • body mass
  • breast cancer
  • cancer survivor
  • constipation
  • controlled study
  • dyspnea
  • European Organization for Research and Treatment of Cancer Quality of Life Questionnaire BR23
  • European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30
  • European Quality of Life 5 Dimensions 3 Level questionnaire
  • fatigue
  • female
  • financial deficit
  • global health
  • health status
  • human
  • human tissue
  • lifestyle modification
  • major clinical study
  • middle aged
  • multicenter study
  • multiple regression
  • nausea and vomiting
  • physical capacity
  • quality of life
  • quality of life assessment
  • randomized controlled trial
  • sexuality
  • social interaction
  • wellbeing
  • breast tumor
  • clinical trial
  • complication
  • diet
  • dietary supplement
  • healthy lifestyle
  • kinesiotherapy
  • patient compliance
  • psychology
  • questionnaire
  • survivorship
  • treatment outcome
  • Adult
  • Breast Neoplasms
  • Cancer Survivors
  • Diet Surveys
  • Diet, Mediterranean
  • Dietary Supplements
  • Exercise Therapy
  • Female
  • Health Status
  • Healthy Lifestyle
  • Humans
  • Middle Aged
  • Patient Compliance
  • Quality of Life
  • Surveys and Questionnaires
  • Survivorship
  • Treatment Outcome


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