ecancermedicalscience

Clinical Study

Exploring factors impacting quality of life in breast cancer patients undergoing adjuvant hormone therapy: insights from a cohort in northeastern Morocco

20 Aug 2026
Hafssa El Hilali, Nassiba Bahra, Sanae Guennouni, Chaymae Chbihi, Samia El Hakym, Diango Keita, Sara Nejjari, Abir Oufrid, Oumaima Siyouri, Lamiae Amaadour, Karima Oualla, Zineb Benbrahim, Touria Bouhafa, Nawfel Mellas, Samira El Fakir, Samia Arifi

Purpose: Considering that the recommended duration of adjuvant hormone therapy in localised breast cancer is at least 5 years, it becomes crucial to investigate the quality of life (QOL) of these patients and the factors influencing it.

Objectives: To assess the QOL and identify factors impacting it in patients with localised hormone-sensitive breast cancer receiving adjuvant hormone therapy.

Methods: We surveyed 335 patients with localised hormone-sensitive breast cancer undergoing adjuvant hormone therapy using the Moroccan Arabic dialect version of the European Organisation for Research and Treatment of Cancer QLQ-C30 questionnaire anonymously, with ethics committee approval and patient consent.

Results: The overall QOL in our patient population was moderate, with positive scores for social functioning, followed by physical, cognitive and emotional functioning. Financial difficulties emerged as the most influential factor affecting patients’ QOL, followed by fatigue, pain and other symptoms. Age-related declines in physical functioning were observed, with symptoms more prevalent, especially diarrhoea, in patients aged 70 years and above (p = 0.009). Urban patients faced a greater financial impact on QOL than rural patients (p = 0.025). Higher education correlated with improved QOL, particularly in physical functioning (p = 0.025). Married individuals demonstrated better overall QOL and fewer symptoms (p = 0.027). Postmenopausal patients exhibited lower ability and a higher loss of appetite (p = 0.027). No significant correlation was found between Union for International Cancer Control stage and QOL. Patey mastectomy was associated with more pain than tumourectomy (p = 0.024). Previous chemotherapy had no overall QOL impact, but users reported less diarrhoea (p = 0.016). Hormone therapy type did not significantly affect overall health status, except for tamoxifen users who demonstrated improved functional roles (p = 0.008). The duration of adjuvant hormone therapy (<5 years or >5 years) showed no significant difference in patient QOL. Associated castration had a significant impact on overall health and role functioning, favouring patients without ovarian suppression (p = 0.034 and p = 0.011). Effective treatment tolerance positively influenced overall QOL, leading to better physical, emotional and cognitive functioning (p < 0.0001), with fewer pronounced symptoms.

Conclusion: Our study indicates that the overall QOL of patients with localised breast cancer under adjuvant endocrine therapy was moderate, and several factors were identified as major influences, each affecting the QOL in distinct ways.

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