Work

Patterns of Change in Emotional and Functional Well-Being Following Breast Cancer Diagnosis

Year: 2025

Type: article

Abstract: BACKGROUND: Understanding the change in emotional well-being (EWB) and functional well-being (FWB) in breast cancer survivors can facilitate targeted support for unmet needs. METHODS: Among 2,767 women with breast cancer in the Carolina Breast Cancer Study Phase 3, we assessed EWB and FWB with the Functional Assessment of Cancer Therapy - Breast instrument at 5 (baseline), 25, and 84 months after diagnosis. We identified well-being trajectories using latent class growth analysis, and relative frequency differences (RFD) with 95% confidence intervals (CI) were estimated for associations between trajectory group membership and demographic or clinical characteristics. RESULTS: Five trajectory groups were identified for both EWB and FWB. Most participants (∼70%) were classified into "good well-being" ("stable high" or "stable medium"). A small percentage (∼10%) fell into "very low baseline" or "early decrease", and the rest were "stable low" (∼20%). Overall, younger vs. older age was associated with "stable low" EWB (25.4% vs. 19.3%; RFD 6.1%; 95% CI, 3.0%-9.2%). Black participants more frequently had "stable low" FWB (24.2% vs. 16.6%; RFD 7.6%; 95% CI, 4.6%-10.6%). Breast cancer recurrence was strongly associated with "stable low" EWB (28.7% vs. 21.3%; RFD 7.3%; 95% CI, 2.3%-12.3%) and FWB (28.7% vs. 19.2%; RFD 8.6%; 95% CI, 3.7%-13.5%). Being unmarried, lower income, having nonprivate insurance, advanced stage, mastectomy vs. breast conservation surgery, and chemotherapy were also predictors of poor well-being trajectories. CONCLUSIONS: Demographics and clinical features are associated with sustained poor well-being after breast cancer. IMPACT: Improvements in long-term well-being may warrant targeted support.

Source: Cancer Epidemiology Biomarkers & Prevention

DOI: 10.1158/1055-9965.epi-24-0849