Study: Friends and family may help breast cancer survival

IN DEPTH REVIEW OF RESEARCH

Study background:

Previous work found an association between better overall survival in cancer patients who had good support networks; however, improved breast cancer-specific mortality has not been studied.

Candyce Kroenke and her colleagues from Kaiser Permanente and other institutions published research in 2016 in the journal Cancer that studied the association between breast cancer-specific mortality and social networks.

Researchers of this study wanted to know:

Does a larger social network help breast cancer survivors have a better prognosis?  

Population(s) looked at in the study:

The 9,267 women in this study were part of the After Breast Cancer Pooling Project (ABCPP) and previously had invasive breast cancer (stage I-IV). The ABCPP included women from multiple United States locations and Shanghai, China.

The researchers measured women’s social networks within two years after their diagnosis, using the Berkman-Syme social network index. This index includes five components:

• spouse/intimate partner
• number of relatives
• friendship ties
• religious/social ties
• community ties

A higher number on the index meant that the women had greater social ties.

Depending on her score, each woman’s data was assigned to one of three groups:

• Socially isolated
• Moderately integrated
• Socially integrated

The women were then followed for up to 21 years (the follow-up time for individuals ranged from about 1 to 21 years) to observe rates of recurrence, breast cancer-specific mortality and overall mortality.

Study findings: 

1. Socially isolated breast cancer survivors had higher risk of recurrence, breast cancer-specific mortality, and overall mortality compared to survivors who had large social networks.
2. Having no spouse/partner and community ties was associated with higher breast cancer-specific mortality in older white women.
3. Having no relatives or friendship ties was associated with higher breast cancer-specific mortality in nonwhite women.

Limitations:

This study did not include many women of lower socioeconomic status, who tend to have smaller social networks and poorer survival. So while not definitive, it is more likely that because of this limitation, the study underestimated the association between social networks and survival. Nor did this study include many African American or Hispanic women. Finally, the study authors acknowledged that having later stage disease, such as metastatic breast cancer, could be a factor in determining social network size.                         

Conclusions:

This study suggests that not having a large social network is associated with poorer outcomes after breast cancer, though more work needs to be done to understand why. Women who have had breast cancer should reach out to their family, friends, health care providers, and other support groups if they need support or assistance.

Posted 3/16/17

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