Correlates of fear of cancer recurrence in women with ductal carcinoma in situ and early invasive breast cancer
Identifieur interne : 004337 ( Ncbi/Merge ); précédent : 004336; suivant : 004338Correlates of fear of cancer recurrence in women with ductal carcinoma in situ and early invasive breast cancer
Auteurs : Ying Liu ; Maria Pérez ; Mario Schootman ; Rebecca L. Aft ; William E. Gillanders ; Donna B. JeffeSource :
- Breast cancer research and treatment [ 0167-6806 ] ; 2011.
Abstract
Fear of cancer recurrence (FCR) is a common and persistent concern among breast cancer survivors. Little is known about factors associated with FCR in women with ductal carcinoma in situ (DCIS) or early invasive breast cancer (EIBC). Women with first primary DCIS, or stages I–IIA breast cancer were prospectively enrolled in a quality-of-life study and completed interviews at 4–6 weeks, 6 months, and 2 years after definitive surgical treatment. In three stepwise multivariable linear regression models, including both time-independent and time-varying variables measured at each respective interview, we identified independent correlates of mean FCR scores (range 1–6) using four items from the Concern About Recurrence Scale (CARS) at 2-year follow-up. Of 506 disease-free patients at 2-year follow-up (mean [SD] age, 58 [
Url:
DOI: 10.1007/s10549-011-1551-x
PubMed: 21553295
PubMed Central: 3227390
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<author><name sortKey="Liu, Ying" sort="Liu, Ying" uniqKey="Liu Y" first="Ying" last="Liu">Ying Liu</name>
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<author><name sortKey="Perez, Maria" sort="Perez, Maria" uniqKey="Perez M" first="Maria" last="Pérez">Maria Pérez</name>
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<author><name sortKey="Schootman, Mario" sort="Schootman, Mario" uniqKey="Schootman M" first="Mario" last="Schootman">Mario Schootman</name>
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<author><name sortKey="Aft, Rebecca L" sort="Aft, Rebecca L" uniqKey="Aft R" first="Rebecca L." last="Aft">Rebecca L. Aft</name>
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<author><name sortKey="Gillanders, William E" sort="Gillanders, William E" uniqKey="Gillanders W" first="William E." last="Gillanders">William E. Gillanders</name>
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<author><name sortKey="Perez, Maria" sort="Perez, Maria" uniqKey="Perez M" first="Maria" last="Pérez">Maria Pérez</name>
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<author><name sortKey="Schootman, Mario" sort="Schootman, Mario" uniqKey="Schootman M" first="Mario" last="Schootman">Mario Schootman</name>
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<author><name sortKey="Aft, Rebecca L" sort="Aft, Rebecca L" uniqKey="Aft R" first="Rebecca L." last="Aft">Rebecca L. Aft</name>
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<author><name sortKey="Gillanders, William E" sort="Gillanders, William E" uniqKey="Gillanders W" first="William E." last="Gillanders">William E. Gillanders</name>
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<author><name sortKey="Jeffe, Donna B" sort="Jeffe, Donna B" uniqKey="Jeffe D" first="Donna B." last="Jeffe">Donna B. Jeffe</name>
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<series><title level="j">Breast cancer research and treatment</title>
<idno type="ISSN">0167-6806</idno>
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<front><div type="abstract" xml:lang="en"><p id="P1">Fear of cancer recurrence (FCR) is a common and persistent concern among breast cancer survivors. Little is known about factors associated with FCR in women with ductal carcinoma in situ (DCIS) or early invasive breast cancer (EIBC). Women with first primary DCIS, or stages I–IIA breast cancer were prospectively enrolled in a quality-of-life study and completed interviews at 4–6 weeks, 6 months, and 2 years after definitive surgical treatment. In three stepwise multivariable linear regression models, including both time-independent and time-varying variables measured at each respective interview, we identified independent correlates of mean FCR scores (range 1–6) using four items from the Concern About Recurrence Scale (CARS) at 2-year follow-up. Of 506 disease-free patients at 2-year follow-up (mean [SD] age, 58 [<xref ref-type="bibr" rid="R10">10</xref>
] years; 81% White; 34% DCIS), the average FCR score of 2.0 was low. However, 145 (29%) reported moderate-to-high levels of FCR (scores 3.0–6.0). All three models showed that younger age, stage IIA breast cancer (vs. DCIS), lower social support, and elevated anxiety were consistently associated with higher FCR at 2-year follow-up (each <italic>P</italic>
< 0.05; final models R<sup>2</sup>
= 0.25–0.32). DCIS patients reported lower FCR than stage IIA patients (each <italic>P</italic>
≤ 0.01) but had similar FCR as stage I patients. Although mean FCR was low, 29% of DCIS and EIBC survivors reported moderate-to-high levels of FCR at 2-year follow-up. Management of anxiety, provision of social support, and patient education may help reduce FCR among DCIS and EIBC survivors, especially among younger survivors.</p>
</div>
</front>
</TEI>
<pmc article-type="research-article" xml:lang="en"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<pmc-dir>properties manuscript</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-journal-id">8111104</journal-id>
<journal-id journal-id-type="pubmed-jr-id">1254</journal-id>
<journal-id journal-id-type="nlm-ta">Breast Cancer Res Treat</journal-id>
<journal-title-group><journal-title>Breast cancer research and treatment</journal-title>
</journal-title-group>
<issn pub-type="ppub">0167-6806</issn>
<issn pub-type="epub">1573-7217</issn>
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<article-meta><article-id pub-id-type="pmid">21553295</article-id>
<article-id pub-id-type="pmc">3227390</article-id>
<article-id pub-id-type="doi">10.1007/s10549-011-1551-x</article-id>
<article-id pub-id-type="manuscript">NIHMS338434</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Article</subject>
</subj-group>
</article-categories>
<title-group><article-title>Correlates of fear of cancer recurrence in women with ductal carcinoma in situ and early invasive breast cancer</article-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Liu</surname>
<given-names>Ying</given-names>
</name>
<aff id="A1">Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, 660 South Euclid Avenue, Campus Box 8100, St. Louis, MO 63110, USA</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Pérez</surname>
<given-names>Maria</given-names>
</name>
<aff id="A2">Division of Health Behavior Research, Department of Internal Medicine, Washington University School of Medicine, St. Louis, MO, USA</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Schootman</surname>
<given-names>Mario</given-names>
</name>
<aff id="A3">Division of Health Behavior Research, Department of Internal Medicine, Washington University School of Medicine, St. Louis, MO, USA; Alvin J. Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis, MO, USA</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Aft</surname>
<given-names>Rebecca L.</given-names>
</name>
<aff id="A4">Alvin J. Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis, MO, USA; Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA; John Cochran Veterans Administration Hospital, St. Louis, MO, USA</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Gillanders</surname>
<given-names>William E.</given-names>
</name>
<aff id="A5">Alvin J. Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis, MO, USA; Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Jeffe</surname>
<given-names>Donna B.</given-names>
</name>
<aff id="A6">Division of Health Behavior Research, Department of Internal Medicine, Washington University School of Medicine, St. Louis, MO, USA; Alvin J. Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis, MO, USA</aff>
</contrib>
</contrib-group>
<author-notes><corresp id="CR1"><email>liuyi@wudosis.wustl.edu</email>
</corresp>
</author-notes>
<pub-date pub-type="nihms-submitted"><day>23</day>
<month>11</month>
<year>2011</year>
</pub-date>
<pub-date pub-type="epub"><day>8</day>
<month>5</month>
<year>2011</year>
</pub-date>
<pub-date pub-type="ppub"><month>11</month>
<year>2011</year>
</pub-date>
<pub-date pub-type="pmc-release"><day>30</day>
<month>11</month>
<year>2011</year>
</pub-date>
<volume>130</volume>
<issue>1</issue>
<fpage>165</fpage>
<lpage>173</lpage>
<permissions><copyright-statement>© Springer Science+Business Media, LLC. 2011</copyright-statement>
<copyright-year>2011</copyright-year>
</permissions>
<abstract><p id="P1">Fear of cancer recurrence (FCR) is a common and persistent concern among breast cancer survivors. Little is known about factors associated with FCR in women with ductal carcinoma in situ (DCIS) or early invasive breast cancer (EIBC). Women with first primary DCIS, or stages I–IIA breast cancer were prospectively enrolled in a quality-of-life study and completed interviews at 4–6 weeks, 6 months, and 2 years after definitive surgical treatment. In three stepwise multivariable linear regression models, including both time-independent and time-varying variables measured at each respective interview, we identified independent correlates of mean FCR scores (range 1–6) using four items from the Concern About Recurrence Scale (CARS) at 2-year follow-up. Of 506 disease-free patients at 2-year follow-up (mean [SD] age, 58 [<xref ref-type="bibr" rid="R10">10</xref>
] years; 81% White; 34% DCIS), the average FCR score of 2.0 was low. However, 145 (29%) reported moderate-to-high levels of FCR (scores 3.0–6.0). All three models showed that younger age, stage IIA breast cancer (vs. DCIS), lower social support, and elevated anxiety were consistently associated with higher FCR at 2-year follow-up (each <italic>P</italic>
< 0.05; final models R<sup>2</sup>
= 0.25–0.32). DCIS patients reported lower FCR than stage IIA patients (each <italic>P</italic>
≤ 0.01) but had similar FCR as stage I patients. Although mean FCR was low, 29% of DCIS and EIBC survivors reported moderate-to-high levels of FCR at 2-year follow-up. Management of anxiety, provision of social support, and patient education may help reduce FCR among DCIS and EIBC survivors, especially among younger survivors.</p>
</abstract>
<kwd-group><kwd>Breast cancer</kwd>
<kwd>Ductal carcinoma in situ</kwd>
<kwd>Cancer risk perception</kwd>
<kwd>Fear of cancer recurrence</kwd>
<kwd>Anxiety</kwd>
<kwd>Social support</kwd>
</kwd-group>
<funding-group><award-group><funding-source country="United States">National Cancer Institute : NCI</funding-source>
<award-id>R01 CA102777-05 || CA</award-id>
</award-group>
</funding-group>
</article-meta>
</front>
</pmc>
<affiliations><list></list>
<tree><noCountry><name sortKey="Aft, Rebecca L" sort="Aft, Rebecca L" uniqKey="Aft R" first="Rebecca L." last="Aft">Rebecca L. Aft</name>
<name sortKey="Gillanders, William E" sort="Gillanders, William E" uniqKey="Gillanders W" first="William E." last="Gillanders">William E. Gillanders</name>
<name sortKey="Jeffe, Donna B" sort="Jeffe, Donna B" uniqKey="Jeffe D" first="Donna B." last="Jeffe">Donna B. Jeffe</name>
<name sortKey="Liu, Ying" sort="Liu, Ying" uniqKey="Liu Y" first="Ying" last="Liu">Ying Liu</name>
<name sortKey="Perez, Maria" sort="Perez, Maria" uniqKey="Perez M" first="Maria" last="Pérez">Maria Pérez</name>
<name sortKey="Schootman, Mario" sort="Schootman, Mario" uniqKey="Schootman M" first="Mario" last="Schootman">Mario Schootman</name>
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