Objectives Breast cancer (BC) is prevalent in low and middle-income countries (LMICs) where the majority of cases are diagnosed in late stages. The aims of this study were:
(1) to assess quality of life (QOL) and health status of Indonesian women with BC symptoms before definitive diagnosis;
(2) to compare QOL and health status between women with BC symptoms before definitive diagnosis and Indonesian women in general;
(3) to evaluate the association between demographic variables (age, residence, social economic status and education level) and QOL within the Indonesian women with BC symptoms before definitive diagnosis.
Methods We used WHOQOL-BREF to measure QOL and EQ-5D-5L for health status. Multivariate analysis of covariance (MANCOVA) was used to compare QOL and health status between women with BC symptoms and women from the general Indonesian population in order to control for confounders. Regression analyses were used for testing the association between the demographic variables, QOL, and health status.
Results In comparison with the data from the women from the general population (n = 471), the women with BC symptoms (n = 132) reported lower QOL, especially in physical and psychological domains. They also reported more problems in all dimensions of health status. Higher education and monthly income were positively associated with QOL and health status among the women with BC symptoms.
Conclusion Before receiving a definitive diagnosis, women who visit hospitals with symptoms of BC, report a lower QOL and health status than women in general. Our results suggest that healthcare providers should provide targeted strategies for women with BC symptoms to improve their QOL.

Additional Metadata
Persistent URL dx.doi.org/10.1371/journal.pone.0200966, hdl.handle.net/1765/109537
Journal PLoS ONE
Citation
Setyowibowo, H. (Hari), Purba, F.D, Hunfeld, J.A.M, Iskandarsyah, A, Sadarjoen, S.S, Passchier, J, & Sijbrandij, M. (2018). Quality of life and health status of Indonesian women with breast cancer symptoms before the definitive diagnosis. PLoS ONE, 13(7). doi:10.1371/journal.pone.0200966