Authors: Candyce H Kroenke Yvonne Michael Hilary Tindle Elizabeth Gage Rowan Chlebowski Lorena Garcia Catherine Messina JoAnn E Manson Bette J Caan
Publish Date: 2012/02/14
Volume: 133, Issue: 1, Pages: 375-385
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 4530 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 firstdegree relatives before diagnosis Of those 354 died during followup with 190 from breast cancer We used Cox proportional hazards regression to evaluate associations of social network members with risk of postdiagnosis mortality further evaluating associations by social support and social burden caregiving social strain In multivariateadjusted analyses among women with high but not low social support being married was related to lower allcause mortality By contrast among women with high but not low social burden those with a higher number of firstdegree relatives including siblings parents and children had higher allcause and breast cancer mortality among caregivers 0–3 relatives ref 4–5 relatives HR = 147 95 CI 062–352 6–9 relatives HR = 208 95 CI 089–486 10+ relatives HR = 355 95 CI 135–933 Pcontinuous = 002 Pinteraction = 0008 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
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