Health Related Quality of Life Among Women with Breast Cancer in Mogadishu, Somalia

Background: Breast cancer is a leading contributor to cancer-related illness and death among women worldwide. In Somalia, limited access to healthcare exacerbates the challenges faced by patients, making health-related quality of life (HRQoL) a vital concern. Objective: To assess health related quality of life among women with breast cancer in Mogadishu, Somalia. Methods: A hospital-based cross-sectional study was conducted from September to November 2024 involving 200 breast cancer patients. Data were collected using a structured questionnaire adapted from the validated European Organization for Research and Treatment of Cancer quality of life instruments (EORTC QLQ-C30 and the breast cancer-specific module EORTC QLQ-BR23). These tools were used to assess multiple domains of health-related quality of life. Data were analyzed using SPSS version 27. Descriptive statistics were used to summarize participant characteristics. Pearson’s correlation examined relationships between HRQoL domains and socio-demographic or clinical variables. Multivariable linear regression was used to identify independent predictors of HRQoL, with significance set at p < 0.05. Results: In multivariable linear regression, advanced stage at diagnosis was associated with lower physical (β = – 0.109, 95% CI: – 0.202 to – 0.016, p = 0.021) and emotional HRQoL (β = – 1.192, 95% CI: – 1.330 to – 0.954, p = 0.007), and with higher financial burden (β = 1.41, 95% CI: 1.061 to 1.760, p = 0.021). Greater extent of surgery predicted lower physical HRQoL (β = – 0.469, 95% CI: – 0.587 to – 0.351, p < 0.001). Adequate social support was positively associated with conjugal well-being (β = 0.334, 95% CI: 0.020 to 0.649, p = 0.037), and stage at diagnosis was also positively linked with conjugal HRQoL (β = 0.343, 95% CI: 0.039 to 0.647, p = 0.027). Conclusion: Although emotional and social HRQoL were relatively preserved, physical, financial, and conjugal domains were more negatively affected especially among women with advanced cancer, extensive surgery, or longer time since diagnosis. These findings emphasize the urgent need for improved cancer care access and integrated psychosocial support in Somalia. Keywords: breast cancer, health-related quality of life, mogadishu, Somalia