Table 4 Sources of evidence to estimate the health-related quality of life

Without adjustment of age

 Naeim et al. (2005) [18] and Naeim et al. (2005) [19]

Disease-free

Baseline

Progression:

hormone therapy

minor toxicity with chemotherapy

major toxicity with chemotherapy

Not reported

Expert elicitation [67, 68]

45 years

65 years

75 years

85 years

150

Not reported

No

 Desch et al. (1993) [24]

Disease-free

Well

Progression:

First recurrence

Side effect

Minor toxicity with chemotherapy

Major toxicity with chemotherapy

Not reported

Assumptions

60 years

65 years

70 years

75 years

80 years

NA

NA

With adjustment of age

Skedgel, et al. (2013) [21]

Disease-free:

Disease-free baseline varied by age

Progression:

First local recurrence

Second local recurrence

Well after relapse

Distant recurrence

Side effect

Congestive heart failure

Febrile neutropenia

AML/MDS

Nausea/vomiting

EQ-5D-3L from previous literature [26] for baseline value

Utilities for side effects:

from the Cost-Effectiveness Analysis Registry without reporting data source

40 years

50 years

60 years

70 years

80 + years

2981,

74 years [26]

Not reported for side effects

Partial adjustment:

Age-dependent baseline values and fixed progression state values

 Sen et al. (2014) [20]

1. Health states

Disease-free:

Surgery alone

Surgery by different adjuvant treatments

Progression:

Recurrence

Distant metastasis

2. Utility modifier

70–74 y

75–79 y

80–84 y

 > 85 y

1.EQ-5D from previous literature [27]

2.Standard gamble from previous literature [69]

70, 75, and 80 + years

97 patients with median age at 56 years [27]. Not reported [69]

Disutility multiplier to adjust standard gamble utilities by the mean age-dependent EQ-5D utilities in the general population

 Ward et al. (2020) [22]

and

Ward et al. (2019) [23]

1. Utility

Disease-free

Baseline

2. Disutility value:

Progression

Distant metastasis

Second malignancy: radiation Induced

salvage mastectomy

salvage axillary dissection after axillary recurrence

Side effect

Fracture

Second malignancy: endometrial cancer

salvage lumpectomy with radiation

treatment of contralateral cancer

Cardiac adverse event (MI)

DVT

Acute radiation dermatitis, Grade 3

Hot flashes

Arthralgia

Late radiation-induced fibrosis

1. Utility

EQ-5D from a cross-sectional U.S. population survey 2005 [28]

2. Disutility from previous economic evaluation [70]

70 years or older

965 patients of a sub-cohort aged 65–74 years [28]

Age-dependent baseline values and health-state utilities with an additive utility decrement