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Cited by 162Cancer survivorship and careHealth disparities and outcomesGlobal Cancer Incidence and Screening

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

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Kroenke, Candyce H., Quesenberry, Charles, Kwan, Marilyn L., Sweeney, Carol, Castillo, Adrienne, Caan, Bette J.·2013·Breast Cancer Research and Treatment
DOI 10.1007/s10549-012-2253-8PMC PMC4019377
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Abstract

Larger social networks have been associated with lower breast cancer mortality. The authors evaluated how levels of social support and burden influenced this association. We included 2,264 women from the Life After Cancer Epidemiology study who were diagnosed with early-stage, invasive breast cancer between 1997 and 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. 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 from friends and family, 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 versus noncaregivers. Larger social networks predicted better prognosis after breast cancer, but associations depended on the quality and burden of family relationships.

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Authors
Kroenke, C. H., Quesenberry, C., Kwan, M. L., Sweeney, C., Castillo, A., & Caan, B. J.
Affiliations
  • Kaiser Permanente (US)
  • University of Utah (US)
Corresponding author
Kroenke, Candyce H.
ORCID
Venue
Breast Cancer Research and Treatment
Publisher
Springer Science and Business Media LLC
Published
2012-11-10
Volume
137
Issue
1
Pages
261-271
ISSN
  • 0167-6806 (ISSN-L)
  • 1573-7217
DOI
10.1007/s10549-012-2253-8
PMC
PMC4019377
OpenAlex
W2026142354
Cited by
162
References
57
Citations by year
2026: 8 · 2025: 11 · 2024: 11 · 2023: 17 · 2022: 17 · 2021: 16 · 2020: 15 · 2019: 9 · 2018: 14 · 2017: 17 · 2016: 9 · 2015: 8 · 2014: 3 · 2013: 4
FWCI
2.37
Type
journal article
Language
en
Open access
Licence
www.springer.com/tdm (tdm)
Locations
  • Breast Cancer Research and Treatment (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Cancer Institute (R01CA129059)
Topics
  • Health Sciences › Medicine › Oncology › Cancer survivorship and care
  • Social Sciences › Health › Health disparities and outcomes
  • Health Sciences › Medicine › Oncology › Global Cancer Incidence and Screening
Keywords
breast cancer, social networks, social support, social burden, social isolation, all-cause mortality, breast cancer-specific mortality, caregiving, religious participation, volunteering, family relationships, prognosis
MeSH terms
Breast Neoplasms, Family Characteristics, Female, Humans, Quality of Life, Social Support, Proportional Hazards Models, Caregivers, Cost of Illness, Kaplan-Meier Estimate, Social Networking

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