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Emotional well-being years post-treatment for breast cancer: prospective, multi-ethnic, and population-based analysis

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Abstract

Purpose

This study investigated factors associated with declines in emotional well-being (EWB) over time in breast cancer survivors.

Methods

Women with breast cancer (Stages I–III) residing in Los Angeles, CA, or Detroit, MI, and reported to the Surveillance, Epidemiology, and End Results registries between June 2005 and February 2007 completed surveys at 9 months and 4 years after diagnosis. EWB was measured by the Functional Assessment of Cancer Treatment-Breast. Using a stress coping framework, logistic regression models assessed associations between personal, social, and clinical correlates, appraisal (e.g., worry about recurrence) and coping factors (e.g., emotional support) to EWB declines.

Results

Among eligible women who completed primary breast cancer treatment, 772 completed both surveys, and 192 (24.9 %) experienced EWB declines over time. Women with past or current depression were more likely to report EWB decline (p < 0.01). Survivors who perceived they did not receive enough information about risk of breast cancer recurrence during primary treatment were more likely to have EWB decline (OR 0.53, 95 % CI 0.32–0.87). Greater perceived likelihood of recurrence (OR 1.95, 95 % CI 1.01–5.29) and increased worry about recurrence (OR 1.38, 95 % CI 1.10–1.72) were associated with EWB decline. Higher spirituality beliefs and practices were associated with EWB decline.

Conclusions

A considerable number of breast cancer patients report emotional well-being declines over time. Early identification of women who are vulnerable, such as women with past depression, is crucial to improve quality of care. Women would benefit from education about cancer recurrence and tailored strategies to manage worry about recurrence over time.

Implication for cancer survivors

Understanding actual risk of recurrence and managing worry about recurrence is important for cancer survivors. Emotional concerns are common for individuals with cancer so survivors should feel free to reach out and discuss such concerns with providers well into the survivorship period.

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Ethical standards

This study was approved by the University of Michigan Institutional Review Board. All persons gave their informed consent prior to their inclusion in the study.

Conflicts of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Health Behavior and Health Education, School of Public Health, University of Michigan, 1415 Washington Heights, 2830-SPH1, Ann Arbor, MI, 48109-2029, USA

    Nancy K. Janz

  2. School of Nursing Division III, University of Michigan, 4162 SNB, Ann Arbor, MI, 48109-5482, USA

    Christopher R. Friese

  3. Biostatistics, M4015 SPH II, 2029, University of Michigan, Ann Arbor, MI, USA

    Yun Li

  4. Cancer Institute of New Jersey, Robert Wood Johnson Medical School, 195 Little Albany Street, New Brunswick, NJ, 08901, USA

    John J. Graff

  5. University of Southern California Norris Center, Preventive Medicine, 1441 Eastlake Avenue, MC 9175, Los Angeles, CA, 90089-9175, USA

    Ann S. Hamilton

  6. University of Michigan Internal Medicine-General Medicine, NCRC 2800, Plymouth Road Building, 16-40GE, Ann Arbor, MI, USA

    Sarah T. Hawley

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  1. Nancy K. Janz
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  2. Christopher R. Friese
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  3. Yun Li
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  4. John J. Graff
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  5. Ann S. Hamilton
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  6. Sarah T. Hawley
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Correspondence to Nancy K. Janz.

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Janz, N.K., Friese, C.R., Li, Y. et al. Emotional well-being years post-treatment for breast cancer: prospective, multi-ethnic, and population-based analysis. J Cancer Surviv 8, 131–142 (2014). https://doi.org/10.1007/s11764-013-0309-3

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  • DOI: https://doi.org/10.1007/s11764-013-0309-3

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