Functional Assessment of Cancer Therapy-Breast (FACT-B)
Functional Assessment of Cancer Therapy-Breast · Also known as: FACT-B, FACT-Breast
The FACT-B is a comprehensive 36-item disease-specific quality-of-life instrument that integrates the generic FACT-G (27 items covering physical, social, emotional, and functional well-being) with a 9-item breast-cancer-specific subscale addressing body image, sexual function, arm symptoms, and treatment side effects. Developed by Brady et al. in 1997, the FACT-B is the gold-standard QoL measure for breast cancer research and clinical practice, used in hundreds of clinical trials and enabling comparison across breast cancer populations and treatment modalities.
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When to use it
FACT-B is the standard QoL instrument for all breast cancer research and clinical contexts: randomized controlled trials comparing systemic therapies, surgery, radiation, or endocrine therapy; supportive care trials (psychotherapy, exercise, sexual rehabilitation); observational studies of long-term QoL and survivorship outcomes; routine oncology clinic assessment to monitor patient-reported outcomes and guide survivorship care planning. FACT-B is also used to compare outcomes across different breast cancer subtypes (hormone receptor-positive, HER2-positive, triple-negative) and treatment eras. Particularly valuable for research on younger breast cancer patients or those with special concerns (pregnancy, sexuality, body image).
Strengths & limitations
- Disease-specific design: FACT-G core preserves comparability with other cancer types; breast-specific subscale captures unique treatment-related and body-image concerns. Enables comparison across cancer types (breast vs. ovarian vs. lung) and breast-subtype-specific research.
- Extensively validated: Robust psychometric properties in thousands of breast cancer patients; strong internal consistency (Cronbach α ≥0.85 per subscale) and test–retest reliability (ICC ≥0.80). Responsive to clinical change with surgery, systemic therapy, and supportive interventions.
- Comprehensive yet practical: 36 items balances multidimensional assessment with feasible administration time (~10–12 min). Subscale clarity enables targeted intervention planning.
- Published norms stratified by age, treatment phase, and breast cancer subtype. Extensive literature enabling benchmarking against reference cohorts.
- Breast-specific subscale (9 items) is relatively brief; may not capture all relevant breast-cancer-related QoL domains (e.g., reconstruction satisfaction, genetic testing anxiety, hereditary cancer concerns). Supplementary instruments may be needed for detailed assessment.
- Some ceiling effect in survivor populations with minimal residual burden; may not detect subtle improvements in already-high QoL groups.
- Emotional subscale (6 items) is brief; anxiety, depression, or post-traumatic stress may require dedicated screening (PHQ-9, GAD-7, PCL-6) for comprehensive mental health assessment.
- Requires literacy; may need interviewer administration or adapted response formats for populations with cognitive impairment or vision/hearing limitations.
Frequently asked
How is FACT-B different from FACT-G?
FACT-G (27 items, 4 subscales) is a generic cancer QoL measure applicable to all cancer types. FACT-B adds 9 breast-cancer-specific items (body image, sexuality, arm symptoms, treatment side effects) to FACT-G, creating a comprehensive breast-specific measure (36 items, 5 subscales). FACT-G is used when comparing across cancer types; FACT-B is used when breast-cancer-specific detail is essential (clinical trials, survivorship planning in breast cancer populations).
What are typical FACT-B scores in breast cancer populations?
Published mean total FACT-B scores vary by treatment phase: early-stage, newly diagnosed: ~95–105; during active chemotherapy: ~75–85; post-treatment (3–12 months): ~105–120; long-term survivors (>5 years): ~115–125. Breast-specific subscale means: early-stage ~24–28; post-treatment ~26–32. Use treatment-phase and age-stratified reference data for proper contextualization.
Can FACT-B be used in male breast cancer patients?
FACT-B was developed in and validated primarily in female breast cancer patients. Use in men requires careful consideration of items specifically referencing female anatomy or sexuality. Some items (e.g., 'I feel sexually attractive') may require rephrasing for cultural or anatomical appropriateness. Consultation with male breast cancer patients and literature review of male-specific adaptations is recommended before using standard FACT-B in male populations.
What is a clinically meaningful change in FACT-B scores?
Total FACT-B change of ≥7–10 points is generally considered clinically meaningful, with variability based on baseline QoL and intervention type. Breast-specific subscale changes of ≥3–5 points are meaningful. Effect-size benchmarks (Cohen d, small ~0.2, medium ~0.5, large ~0.8) supplement raw score interpretation. Anchor-based minimal clinically important differences specific to breast cancer populations are preferable when available.
Sources
- Brady, M. J., Cella, D. F., Mo, F., et al. (1997). Reliability and validity of the Functional Assessment of Cancer Therapy-Breast quality-of-life instrument. J Clin Oncol, 15(3), 974–986. DOI: 10.1200/JCO.1997.15.3.974 ↗
- Cella, D. F., Tulsky, D. S., Gray, G., et al. (1993). The Functional Assessment of Cancer Therapy scale: development and validation of a general measure. J Clin Oncol, 11(3), 570–579. DOI: 10.1200/JCO.1993.11.3.570 ↗
How to cite this page
ScholarGate. (2026, June 3). Functional Assessment of Cancer Therapy-Breast. ScholarGate. https://scholargate.app/en/oncology-nursing/fact-b-breast-cancer
Which method?
Set this method beside its closest kin and read them side by side — the library lays the books on the table; the choice is yours.
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