Yumeng Ren, Joanna Maselko, Xianming Tan, Andrew F Olshan, Angela M Stover, Antonia V Bennett, Marc A Emerson, Melissa A Troester
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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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>Demographics and clinical features are associated with sustained poor well-being after breast cancer.</p><p><strong>Impact: </strong>Improvements in long-term well-being may warrant targeted support.</p>","PeriodicalId":9458,"journal":{"name":"Cancer Epidemiology Biomarkers & Prevention","volume":" ","pages":"676-683"},"PeriodicalIF":3.7000,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Patterns of Change in Emotional and Functional Well-Being Following Breast Cancer Diagnosis.\",\"authors\":\"Yumeng Ren, Joanna Maselko, Xianming Tan, Andrew F Olshan, Angela M Stover, Antonia V Bennett, Marc A Emerson, Melissa A Troester\",\"doi\":\"10.1158/1055-9965.EPI-24-0849\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Understanding the change in emotional well-being (EWB) and functional well-being (FWB) in breast cancer survivors can facilitate targeted support for unmet needs.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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%). 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引用次数: 0
摘要
背景：了解乳腺癌（BC）幸存者的情绪和功能幸福感（EWB和FWB）变化可以促进对未满足需求的有针对性的支持。方法：在卡罗莱纳乳腺癌研究3期的2767名BC女性中，我们在诊断后5个月（基线）、25个月和84个月用肿瘤治疗功能评估-乳腺（FACT-B）仪器评估EWB和FWB。我们使用潜在类别增长分析确定了幸福轨迹，并估计了轨迹群体成员与人口统计学或临床特征之间的关联的相对频率差异（rfd）和95%置信区间（ci）。结果：EWB和FWB均有5个轨迹组。大多数参与者（约70%）被划分为“良好的幸福”（“稳定的高”或“稳定的中等”）。一小部分（~10%）处于“非常低的基线”或“早期下降”，其余为“稳定的低”（~20%）。总体而言，年轻和年长与“稳定低”EWB相关(25.4%对19.3%；相对频率差[RFD] 6.1% [95% CI: 3.0%-9.2%])。黑人参与者更频繁地拥有“稳定的低”FWB (24.2% vs. 16.6%；RFD为7.6% [95% ci: 4.6%-10.6%])。BC复发与“稳定低”EWB密切相关(28.7% vs. 21.3%；RFD 7.3% (95% CI: 2.3% - -12.3%))和欢心(28.7% vs . 19.2%;RFD为8.6% [95% ci: 3.7%-13.5%])。未婚、收入较低、有非私人保险、晚期、乳房切除术、乳房保护手术和化疗也是健康状况不佳的预测因素。结论：人口统计学和临床特征与BC术后持续的不良幸福感有关。影响：长期福祉的改善可能需要有针对性的支持。
Patterns of Change in Emotional and Functional Well-Being Following Breast Cancer Diagnosis.
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.
期刊介绍：
Cancer Epidemiology, Biomarkers & Prevention publishes original peer-reviewed, population-based research on cancer etiology, prevention, surveillance, and survivorship. The following topics are of special interest: descriptive, analytical, and molecular epidemiology; biomarkers including assay development, validation, and application; chemoprevention and other types of prevention research in the context of descriptive and observational studies; the role of behavioral factors in cancer etiology and prevention; survivorship studies; risk factors; implementation science and cancer care delivery; and the science of cancer health disparities. Besides welcoming manuscripts that address individual subjects in any of the relevant disciplines, CEBP editors encourage the submission of manuscripts with a transdisciplinary approach.
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