Quantifying the Influence of Psychosocial Characteristics, Supportive Care Needs and Quality of Life on Breast Cancer Survival.

Abstract

Objective: To identify the contribution of psychosocial characteristics, supportive care needs, or quality of life on breast cancer survival outcomes.

Methods: This study used data from a population-based longitudinal study involving women diagnosed with invasive breast cancer (n = 3326, response rate = 71%) in Queensland, Australia, 2010-2013, and followed up to 2020. Flexible parametric survival models were used to identify which factors were associated with survival outcomes. Model fit was assessed using D and $R_D^2$ statistics.

Results: Unmet physical and daily living needs, social support, age, stage at diagnosis, tumour grade, clinical subtype and mode of detection explained 39% of survival variability ( $R_D^2$ 0.39; 95% CI 0.33-0.44), with a Harrell's C statistic of 0.84 (95% CI 0.81-0.86). Unmet physical and daily living needs and social support, which fall under the categories of supportive care needs and psychosocial characteristics respectively, were identified as key factors that predict breast cancer survival, explaining 3% of survival variability. When compared to women who had less unmet physical needs and adequate social support (5-year survival: 96.6%, 95% CI 92%-99%), those who had more unmet physical needs and limited social support had poorer breast cancer-specific survival (5-year survival: 86.8%, 95% CI 72%-95%).

Conclusion: The study found that unmet physical and daily living needs and social support play a marginal but significant role in influencing breast cancer outcomes. The findings enhance the current literature regarding the impact of psychosocial characteristics and supportive care needs on breast cancer survival and suggest that integrating psychosocial support and interventions alongside medical treatment may further improve the survival outcomes for women diagnosed with breast cancer.