1. Postdiagnosis social networks and breast cancer mortality in the After Breast Cancer Pooling Project.
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Kroenke, Candyce H., Michael, Yvonne L., Poole, Elizabeth M., Kwan, Marilyn L., Nechuta, Sarah, Leas, Eric, Caan, Bette J., Pierce, John, Shu, Xiao‐Ou, Zheng, Ying, and Chen, Wendy Y.
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BREAST cancer , *SOCIAL networks , *CANCER-related mortality , *CANCER in women , *BREAST tumor diagnosis , *BREAST tumor treatment , *BREAST tumors , *COMPARATIVE studies , *LONGITUDINAL method , *RESEARCH methodology , *MEDICAL cooperation , *MORTALITY , *HEALTH outcome assessment , *PROGNOSIS , *PSYCHOLOGICAL tests , *PUBLIC health surveillance , *RESEARCH , *RESEARCH funding , *SOCIAL participation , *TUMOR classification , *SOCIAL support , *SOCIOECONOMIC factors , *EVALUATION research , *PROPORTIONAL hazards models ,SOCIAL aspects ,CANCER & society - Abstract
Background: Large social networks have been associated with better overall survival, though not consistently with breast cancer (BC)-specific outcomes. This study evaluated associations of postdiagnosis social networks and BC outcomes in a large cohort.Methods: Women from the After Breast Cancer Pooling Project (n = 9267) provided data on social networks within approximately 2 years of their diagnosis. A social network index was derived from information about the presence of a spouse/partner, religious ties, community ties, friendship ties, and numbers of living first-degree relatives. Cox models were used to evaluate associations, and a meta-analysis was used to determine whether effect estimates differed by cohort. Stratification by demographic, social, tumor, and treatment factors was performed.Results: There were 1448 recurrences and 1521 deaths (990 due to BC). Associations were similar in 3 of 4 cohorts. After covariate adjustments, socially isolated women (small networks) had higher risks of recurrence (hazard ratio [HR], 1.43; 95% confidence interval [CI], 1.15-1.77), BC-specific mortality (HR, 1.64; 95% CI, 1.33-2.03), and total mortality (HR, 1.69; 95% CI, 1.43-1.99) than socially integrated women; associations were stronger in those with stage I/II cancer. In the fourth cohort, there were no significant associations with BC-specific outcomes. A lack of a spouse/partner (P = .02) and community ties (P = .04) predicted higher BC-specific mortality in older white women but not in other women. However, a lack of relatives (P = .02) and friendship ties (P = .01) predicted higher BC-specific mortality in nonwhite women only.Conclusions: In a large pooled cohort, larger social networks were associated with better BC-specific and overall survival. Clinicians should assess social network information as a marker of prognosis because critical supports may differ with sociodemographic factors. Cancer 2017;123:1228-1237. © 2016 American Cancer Society. [ABSTRACT FROM AUTHOR]- Published
- 2017
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