Correlates of decline in emotional well-being over time in breast cancer survivors.

Abstract

e19673 Background: Some women experience decline in emotional well-being (EWB) during breast cancer survivorship. We investigated whether receipt of emotional support, and perceived risk or worry about recurrence were associated with declines in EWB in a large diverse population-based sample. Methods: We surveyed 2,245 women newly diagnosed with breast cancer and reported to the Detroit and Los Angeles SEER registries from 6/05-2/06 and merged these data to SEER. Latina and African American (AA) women were oversampled. Women were surveyed again 4 years after diagnosis (expected n=1,520). We report on a preliminary sample of 707 women. Measures included change in EWB over time (decline, same, better [FACT-B]), receipt of emotional support (none, some, quite a bit/a lot) across 7 sources, perceived risk of recurrence (1-5 scale), worry about recurrence (mean of 3-items, 1-5 scale), and race/ethnicity (white, AA, and Latina- low vs. high acculturation). Results: Women reported getting quite a bit/a lot of emotional support from partners (76%), other family (70%) friends (58%) health care providers (53%), other women with breast cancer (50%) religious community (34%), and co-workers (31%). Latinas-low were more likely than other racial/ethnic groups to report no emotional support from health care providers, other women with breast cancer, and friends (ps <0.05). Women who reported no emotional support from providers (vs. quite a bit/a lot) perceived higher recurrence risk (13.1% vs. 5.3%, respectively, p<.01). Younger women and Latinas-low had higher perceived recurrence risk and worry about recurrence (ps < .01). Women with higher perceived risk were more likely to report EWB decline (24.4%) compared to women with low perceived risk (13.5%, p <.01). Women with EWB decline had higher mean worry scores (2.74) versus women who did not have EWB decline (2.40, p = .02). Conclusions: Declines in emotional well-being after breast cancer treatment are associated with perceived risk and worry about recurrence. Low acculturated Latinas are particularly vulnerable. Clinicians play a critical role in providing emotional support and should attend to women’s perceived risk and worry about recurrence, and the relationships to emotional well-being.