Age- and treatment-related associations with health behavior change among breast cancer survivors

Abstract

Objective The aim of this study was to identify demographic and treatment-related factors associated with health-promoting behavior changes after a breast cancer diagnosis. Changes in health behaviors were also evaluated according to weight, exercise, diet and alcohol consumption patterns before breast cancer diagnosis. Materials and methods We examined self-reported behavior changes among 1,415 women diagnosed with breast cancer in the NIEHS Sister Study cohort. Women reported changes in exercising, eating healthy foods, maintaining a healthy body weight, drinking alcohol, smoking, getting enough sleep, spending time with family and friends, and participating in breast cancer awareness events. Results: On average, women were 3.7 years from their breast cancer diagnosis. Overall, 20–36% reported positive changes in exercise, eating healthy foods, maintaining a healthy weight, or alcohol consumption. However, 17% exercised less. With each 5-year increase in diagnosis age, women were 11–16% less likely to report positive change in each of these behaviors (OR=0.84–0.89; p<0.05), except alcohol consumption (OR=0.97; CI: 0.81, 1.17). Women who underwent chemotherapy were more likely to report eating more healthy foods (OR =1.47; 95% CI 1.16–1.86), drinking less alcohol (OR=2.01; 95% CI: 1.01, 4.06), and sleeping enough (OR=1.41; 95% CI: 1.04, 1.91). The majority of women (50–84%) reported no change in exercise, eating healthy foods, efforts to maintain a healthy weight, alcohol consumption, sleep patterns, or time spent with family or friends. Conclusions Many women reported no change in cancer survivorship guideline-supported behaviors after diagnosis. Positive changes were more common among younger women or those who underwent chemotherapy.

Fertility‐related experiences after breast cancer diagnosis in the Sister and Two Sister Studies

“…Of these, 432 women (82%) were premenopausal and had not undergone permanent sterilization and were included in analyses. The majority of the women were non‐Hispanic white with an annual household income ≥$50,000 (Table ) . Breast cancer stage was distributed such that 15% of women were classified with American Joint Committee on Cancer (AJCC) stage 0, 39% with stage I, 32% with stage II, 14% with stage III, and 1% with stage IV disease at diagnosis.…”

“…The majority of the women were non-Hispanic white with an annual household income ≥$50,000 (Table 1). 41,42 Breast cancer stage was distributed such that 15% of women were classified with American Joint Committee on Cancer (AJCC) stage 0, 39% with stage I, 32% with stage II, 14% with stage III, and 1% with stage IV disease at diagnosis. A minority of patients (25%) were diagnosed with breast cancer prior to 2006, the year that the ASCO guidelines regarding fertility and cancer first were published ( Table 1).…”

“…Fertility interest was defined as answering “yes” to the question “Before your breast cancer diagnosis, did you think you wanted to get pregnant at some point in the future?” Fertility discussion was defined as answering “yes” to the question “Did you ever have a discussion with a health care provider about the effect your treatment could have on your future fertility or ability to have children?” The use of fertility preservation was defined as answering “yes” to the question “Before you began treatment, or during your treatment, did you take any additional steps to lessen your chances of becoming infertile as a result of your cancer treatment?” Women who responded “yes” then selected ≥1 of the following response options: cryopreservation of embryos, cryopreservation of unfertilized eggs, cryopreservation of ovarian tissue, and/or gonadotropin‐releasing hormone (GnRH) agonist. Information regarding breast cancer diagnosis, tumor characteristics, and treatment data were abstracted from the medical records as previously described . Endocrine therapy nonadherence was defined as noninitiation or having reported receiving endocrine therapy most of the time, sometimes, rarely, or never (compared with always) among women with estrogen receptor (ER)–positive breast cancer.…”

“…Information regarding breast cancer diagnosis, tumor characteristics, and treatment data were abstracted from the medical records as previously described. [39][40][41] Endocrine therapy nonadherence was defined as noninitiation or having reported receiving endocrine therapy most of the time, sometimes, rarely, or never (compared with always) among women with estrogen receptor (ER)-positive breast cancer.…”

Analysis of Health Behaviors and Personal Values of Childless Women, Pregnant Women and Women Who Recently Delivered

“…The relationship between female gender and better health behaviors is also commonly reported [ 11 , 12 , 45 ]. Women’s health behaviors in regard to cancer prevention [ 46 ] or in women diagnosed with cancer have been studied extensively [ 47 , 48 , 49 ], but the results of these studies are difficult to compare with the results presented in this paper. We have not found other studies including comparable groups of women in whom preconceptional health behaviors were assessed with the use of HBI inventory.…”