Breast cancer is the most common malignancy in women worldwide.  More than 1.5 million new cases are being diagnosed every year making it  the second most common cancer overall.¹ Its incidence is higher in developed nations and also increases with age, Thus post menopausal women are more likely to be diagnosed with this malignancy.²

It is estimated that 1.67 million women were diagnosed worldwide with breast cancer in 2012.³ In India as well the age standardized incidence rates for breast cancer has been increasing and it was estimated that the number of breast cancer  would rise  annually from 153,297 in 2011 to 235,490 cases in 2026.⁴ The major risk factors for development are patients age, family history, early menarche, late menopause, high body mass index, socio economic status, ethnicity and a genetic predisposition for breast cancer.⁵

The early signs of breast cancer are self palpable breast lumps and the definitive diagnosis can be made by histopathological examination of core needle biopsy.^6,7 Mammography is the best screening tool for early detection. Early detection is the key to a good prognosis and survival.^2,3 Treatment of breast cancer could include different therapies like partial or total mastectomy, radiotherapy, and chemotherapy(neo-adjuvant as well as adjuvant) with or without systemic hormonal therapy. Though these modalities are associated with better survival and outcomes they are associated with a negative impact when it comes to quality of life in breast cancer patients and many complications such as pain, fatigue, lymphedema, reduced vaginal lubrication and hot flashes.¹ The extent of these symptoms and side effects vary depending on the specific modalities that are used alone or in combination.

Death rates in breast cancer patients have been declining due to early detection and improved treatment which has paved the way for better understanding of quality of life in surviving breast cancer patients.⁸ Quality of life (QOL) is defined as “an individual’s perception of his/her position in life in the context of the culture and value systems in which he/she lives and in relation to his/her goals ,expectations, standards, and concerns” by the World Health Organization Quality of Life Group.⁹ Quality of life has become a well- accepted outcome measure for cancer patients and an integral part of cancer patient management.¹⁰ It has received increasing attention due to a rising number of new cases, an improved survival rate, and the vital role of the woman in the family.² It not only focuses on physical complications post treatment but equally weighs the negative and positive impact of different treatments on emotional, social and functional well being.

Quality of life is now viewed as a primary endpoint measure for quality of management and care in oncology practice as it shows the patient’s perception of the impact of cancer diagnosis and treatment on their daily living.

In order to assess the short and long term effects of cancer on the quality of life, several cancer-specific health-related quality of life (HRQL) measures have been developed such as the Functional Adjustment to Cancer Therapy (FACT), the European Organization for Research and Treatment of Cancer (EORTC), the Functional Living Index-Cancer (FLIC), the Cancer Rehabilitation Evaluation System (CaRES), and the Quality of Life in Adult Cancer Survivor Scale (QLACS). These questionnaires focus on all aspects of health of a patient-physical, social, functional and mental health to assess the overall quality of life in surviving cancer patients.

A few questionnaires have been specifically developed for the assessment of the HRQL of breast cancers patients. These include the Breast Cancer Chemotherapy Questionnaire (BCQ) (Levine et al, 1988), the Functional Assessment of Cancer Therapy-Breast (FACT-B) questionnaire (Brady et al., 1997), and the European Organization for Research and Treatment of Cancer core questionnaire and breast module (EORTC BR 3) (Sprangers et al., 1996).⁹ Previous studies showed that one quarter to one third of breast cancer patients were detected through screening questionnaires to have distress, anxiety, and depression following breast cancer’s diagnosis and treatment. Symptoms-pain, fatigue, and insomnia were among the most common symptoms reported.⁷

In India, breast cancer is the most common cancer among women with increased incidence of cancer among younger age group of women.¹¹ With increasing awareness about the treatment modalities and easy availability of resources to administer the treatment increased attention is being given to the Quality of life in these women. While many studies have been conducted on treatment and survival of women suffering from breast cancer, the data on Quality of Life and survivorship is very limited. The present study is planned with the objective to understand and to identify the issues causing maximum limitation in their QOL. This information will help in more targeted intervention and overall in providing better health care facilities to survivors.