Social networks, social support, and burden in relationships, and mortality after breast cancer diagnosis in the Life After Breast Cancer Epidemiology (LACE) Study

Abstract

Purpose Larger social networks have been associated with lower breast cancer mortality. The authors evaluated how levels of social support and burden influenced this association. Methods We included 2,264 women from the Life After Cancer Epidemiology study who were diagnosed with breast cancer between 1997–2000, and provided data on social networks (spouse or intimate partner, religious/social ties, volunteering, time socializing with friends, and number of first-degree female relatives), social support, and caregiving. 401 died during a median follow-up of 10.8 years follow-up with 215 from breast cancer. We used delayed entry Cox proportional hazards regression to evaluate associations. Results In multivariate-adjusted analyses, social isolation was unrelated to recurrence or breast cancer-specific mortality. However, socially isolated women had higher all-cause mortality (HR=1.34, 95%CI:1.03–1.73) and mortality from other causes (HR=1.79, 95%CI:1.19–2.68). Levels of social support and burden modified associations. Among those with low, but not high, levels of social support, lack of religious/social participation (HR=1.58, 95%CI: 1.07–2.36, p=0.02, p-interaction=0.01) and lack of volunteering (HR=1.78, 95%CI: 1.15–2.77, p=0.01, p-interaction=0.01) predicted higher all-cause mortality. In cross-classification analyses, only women with both small networks and low levels of support (HR=1.61, 95%CI:1.10–2.38) had a significantly higher risk of mortality than women with large networks and high levels of support; women with small networks and high levels of support had no higher risk of mortality (HR=1.13, 95%CI:0.74–1.72). Social networks were also more important for caregivers vs. noncaregivers. Conclusions Larger social networks predicted better prognosis after breast cancer, but associations depended on the quality and burden of family relationships.

Perceived social support in African American breast cancer patients: Predictors and effects

“…Department of Health and Human Services, 2014). Greater social support is associated with better health and wellbeing, both in the general U.S. population (Galea et al, 2011; Umberson and Montez, 2010; Uchino, 2009) and among cancer survivors (Kroenke et al, 2013; Mols et al, 2005). Social support plays an important role in quality of life and health outcomes after breast cancer diagnosis and treatment (Epplein et al, 2011; Courtens et al, 1996).…”

Determining Chemotherapy Tolerance in Older Patients With Cancer

“…44,45 Identifying a patient’s social network (or lack thereof) involves understanding their support system and identifying who is present for emotional and tangible support (ie, someone to assist in daily activities).…”

Barrier protective use of skin care to prevent chemotherapy-induced cutaneous symptoms and to maintain quality of life in patients with breast cancer

“…Additionally, the severe psychological stress for patients with cancer as well as its social impact has to be taken into account. 4 Therefore, more and more supportive measures are validated in oncology. [5][6][7] This article was published in the following Dove Press journal: Breast Cancer: Targets and Therapy 1 August 2014 Number of times this article has been viewed submit your manuscript | www.dovepress.com…”