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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 &lt; 0.001), physical ( p = 0.003), role ( p = 0.002) and social functioning ( p &lt; 0.001), body image ( p &lt; 0.001), future perspective ( p &lt; 0.001), well-being ( p = 0.001), and reductions in fatigue ( p &lt; 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 &lt; 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.

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