Quality of Life in Women Diagnosed with Breast Cancer after a 12-Month Treatment of Lifestyle Modifications

Nutrients. 2020 Dec 31;13(1):136. doi: 10.3390/nu13010136.


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), constipation (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.

Keywords: breast cancer; lifestyle; mediterranean diet; physical activity; quality of life; vitamin D.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Breast Neoplasms / complications
  • Breast Neoplasms / psychology
  • Breast Neoplasms / therapy*
  • Cancer Survivors / psychology*
  • Diet Surveys / statistics & numerical data
  • Diet, Mediterranean
  • Dietary Supplements
  • Exercise Therapy
  • Female
  • Health Status
  • Healthy Lifestyle*
  • Humans
  • Middle Aged
  • Patient Compliance / statistics & numerical data
  • Quality of Life*
  • Surveys and Questionnaires
  • Survivorship*
  • Treatment Outcome
  • Vitamin D / administration & dosage


  • Vitamin D