Social networks, social support and burden in relationships, and mortality after breast cancer diagnosis

Author(s): Kroenke CH, Michael Y, Tindle H, Gage E, Chlebowski R, et al.

Abstract

Though larger social networks are associated with reduced breast cancer mortality, there is a need to clarify how both social support and social burden influence this association. We included 4,530 women from the Women's Health Initiative who were diagnosed with breast cancer between 1993 and 2009, and provided data on social networks (spouse or intimate partner, religious ties, club ties, and number of first-degree relatives) before diagnosis. Of those, 354 died during follow-up, with 190 from breast cancer. We used Cox proportional hazards regression to evaluate associations of social network members with risk of post-diagnosis mortality, further evaluating associations by social support and social burden (caregiving, social strain). In multivariate-adjusted analyses, among women with high but not low social support, being married was related to lower all-cause mortality. By contrast, among women with high but not low social burden, those with a higher number of first-degree relatives, including siblings, parents, and children, had higher all-cause and breast cancer mortality (among caregivers: 0-3 relatives (ref), 4-5 relatives, HR = 1.47 (95% CI: 0.62-3.52), 6-9 relatives, HR = 2.08 (95% CI: 0.89-4.86), 10+ relatives, HR = 3.55 (95% CI: 1.35-9.33), P-continuous = 0.02, P-interaction = 0.008). The association by social strain was similar though it was not modified by level of social support. Other social network members were unrelated to mortality. Social relationships may have both adverse and beneficial influences on breast cancer survival. Clarifying these depends on understanding the context of women's relationships.

Similar Articles

SEER state fact sheets: Breast Cance

Author(s): National Cancer Institute

US Breast Cancer Statistic

Author(s): American Cancer Society

Latina breast cancer survivors’ lived experiences: Diagnosis, treatment, and beyond

Author(s): Buki LP, Garces DM, Hinestrosa MC, Kogan L, Carrillo IY,

Racism as a stressor for African Americans

Author(s): Clark R, Anderson NB, Clark VR, Williams DR

The African American Women and Mass Media campaign: a CDC breast cancer screening project

Author(s): Hall IJ, Rim SH, Johnson-Turbes CA, Vanderpool R, Kamalu NN

The impact of sociodemographic, treatment, and work support on missed work after breast cancer diagnosis

Author(s): Mujahid MS, Janz NK, Hawley ST, Griggs JJ, Hamilton AS, et al.

Correlates of worry about recurrence in a multiethnic population-based sample of women with breast cancer

Author(s): Janz NK, Hawley ST, Mujahid MS, Griggs JJ, Alderman A, et al.

Racial/ethnic differences in job loss for women with breast cancer

Author(s): Mujahid MS, Janz NK, Hawley ST, Griggs JJ, Hamilton AS, et al.

The influence of black race on treatment and mortality for early-stage breast cancer

Author(s): Berz JP, Johnston K, Backus B, Doros G, Rose AJ, et al.

Critical race theories, colorism, and the decade’s research on families of color

Author(s): Burton LM, Bonilla-Silva E, Ray V, Buckelew R, Freeman EH

Marital status and stage at diagnosis in cancer

Author(s): Nayeri K, Pitaro G, Feldman JG

The meaning of "not giving in"

Author(s): Jensen KP, Bäck-Pettersson S, Segesten K

Spirituality and use of complementary therapies for cure in advanced cancer

Author(s): Trinkaus M, Burman D, Barmala N, Rodin G, Jones J, et al.

Concerns about sexuality after breast cancer

Author(s): Fobair P, Spiegel D

Optimism, social support, and adjustment in African American women with breast cancer

Author(s): Shelby RA, Crespin TR, Wells-Di Gregorio SM, Lamdan RM, Siegel JE, et al.

Racial/ethnic differences in quality of life after diagnosis of breast cancer

Author(s): Janz NK, Mujahid MS, Hawley ST, Griggs JJ, Alderman A, et al.

Types of social support in African Americans with cancer

Author(s): Hamilton JB, Sandelowski M

Understanding the breast cancer experience of Latina women

Author(s): Ashing-Giwa KT, Padilla GV, Bohórquez DE, Tejero JS, Garcia M

Marital stability after breast cancer

Author(s): Dorval M, Maunsell E, Taylor-Brown J, Kilpatrick M

Partner abandonment of women with breast cancer

Author(s): Taylor-Brown J, Kilpatrick M, Maunsell E, Dorval M

Social relations and mortality: a more nuanced approach

Author(s): Antonucci TC, Birditt KS, Webster NJ

Life after breast cancer: understanding women's health-related quality of life and sexual functioning

Author(s): Ganz PA, Rowland JH, Desmond K, Meyerowitz BE, Wyatt GE

Social support and survival in young women with breast carcinoma

Author(s): Chou AF, Stewart SL, Wild RC, Bloom JR

A randomised controlled trial of support group intervention after breast cancer treatment: Results on anxiety and depression

Author(s): Bjorneklett HG, Lindemalm C, Rosenblad A, Ojutkangas M, Letocha H, et al.

Correlates of quality of life among African American and white cancer survivors

Author(s): Matthews AK, Tejeda S, Johnson TP, Berbaum ML, Manfredi C

Self-blame, self-forgiveness, and spirituality in breast cancer survivors in a public sector setting

Author(s): Friedman LC, Barber CR, Chang J, Tham YL, Kalidas M, et al.

The benefits of prayer on mood and well-being of breast cancer survivors

Author(s): Levine EG, Aviv C, Yoo G, Ewing C, Au A

The religiousness as a way of coping with anxiety in women with breast cancer at different disease stages

Author(s): Janiszewska J, Buss T, de Walden-Gałuszko K, Majkowicz M, Lichodziejewska-Niemierko M, et al.

The relationship between unmet needs and distress amongst young people with cancer

Author(s): Dyson GJ, Thompson K, Palmer S, Thomas DM, Schofield P

Mind-body therapies in integrative oncology

Author(s): Elkins G, Fisher W, Johnson A

An overview of art therapy interventions for cancer patients and the results of research

Author(s): Geue K, Goetze H, Buttstaedt M, Kleinert E, Richter D, et al.

Restorative yoga for women with breast cancer: findings from a randomized pilot study

Author(s): Danhauer SC, Mihalko SL, Russell GB, Campbell CR, Felder L, et al.