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Pre-diagnostic allostatic load and health-related quality of life in a cohort of Black breast cancer survivors

  • Epidemiology
  • Published:
Breast Cancer Research and Treatment Aims and scope Submit manuscript

Abstract

Purpose

To determine the association of pre-diagnostic allostatic load (AL) with health-related quality of life (HRQOL) among Black women with breast cancer.

Methods

In a sample of 409 Black women with non-metastatic breast cancer enrolled in the Women’s Circle of Health Follow-Up Study (WCHFS), two pre-diagnostic AL measures were estimated using medical records data from up to 12 months prior to breast cancer diagnosis: AL-lipid/metabolic profile-based measure and AL-inflammatory profile-based measure. HRQOL was assessed approximately 24 months post diagnosis, using the Functional Assessment of Cancer Therapy-Breast Cancer (FACT-B) instrument, including 5 subscale scores [presented by physical well-being (PWB), social & family well-being (SFWB), emotional well-being (EWB), functional well-being (FWB), and breast cancer-specific scale (BCS)] and 3 derived total scores [presented by trial outcome index (TOI), Functional Assessment of Cancer Therapy-General (FACT-G) and FACT-B]. We used multivariable logistic regression models, using dichotomized AL scores (lower AL: 0–3 points, higher AL: 4–8 points), to assess the associations between the two pre-diagnostic AL measures and HRQOL.

Results

Higher pre-diagnostic AL was associated with poorer FWB and lower FACT-G, but these associations were statistically significant for the AL-inflammatory profile-based measure (FWB: OR 1.63, 95% CI 1.04, 2.56; FACT-G: OR 1.62, 95% CI 1.04, 2.54), but not the AL-lipid/metabolic profile-based measure (FWB: OR 1.45, 95% CI 0.81, 2.59; FACT-G: OR 1.33, 95% CI 0.75, 2.37).

Conclusion

These findings suggest that higher AL, particularly when measured using the inflammatory profile-based measure, was associated with poorer HRQOL, namely FWB and FACT-G, among Black breast cancer survivors.

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Acknowledgements

This work was supported in part by grants from the National Cancer Institute of the National Institutes of Health under the following grant numbers: P01CA151135 (awarded to C. B. Ambrosone), P30CA072720 (awarded to S. Libutti), R01CA100598 (awarded to C. B. Ambrosone), R01CA185623 (awarded to E. V. Bandera, K. Demissie, and C. Hong), K01CA193527 (awarded to A. A. M. Llanos), K07CA222158 (awarded to J. J. Plascak). This work was supported in part by grants from the National Institute on Minority Health and Health Disparities of the National Institutes of Health, under grant number K99MD013300 (awarded to B. Qin). Research reported in this publication was also supported by funding from the U.S. Army Medical Research and Development Command under award number DAMD-17-01-1-0334 (awarded to D. H. Bovbjerg), the Breast Cancer Research Foundation (awarded to C. B. Ambrosone and C. Hong), and a gift from the Philip L. Hubbell Family (awarded to K. Demissie). The New Jersey State Cancer Registry, Cancer Epidemiology Services, New Jersey Department of Health, is funded by the Surveillance, Epidemiology and End Results (SEER) Program of the National Cancer Institute under contract HHSN261201300021I and control No. N01-PC-2013-00021, the National Program of Cancer Registries (NPCR), Centers for Disease Control and Prevention under grant NU5U58DP006279-02-00 as well as the State of New Jersey and the Rutgers Cancer Institute of New Jersey. We would like to acknowledge all members of the research team at the Rutgers School of Public Health, Rutgers Cancer Institute of New Jersey, New Jersey State Cancer Registry, and Roswell Park Comprehensive Cancer Center for their contributions to this study, as well as all study participants for their time, commitment, and participation.

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Authors and Affiliations

  1. Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Piscataway, NJ, USA

    Cathleen Y. Xing, Michelle Doose, Yong Lin, Jesse J. Plascak, Elisa V. Bandera & Adana A. M. Llanos

  2. Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA

    Michelle Doose, Bo Qin, Yong Lin, Jesse J. Plascak, Elisa V. Bandera & Adana A. M. Llanos

  3. Department of Medicine, Robert Wood Johnson Medical School, New Brunswick, NJ, USA

    Bo Qin & Elisa V. Bandera

  4. Division of Preventive Medicine, University of Alabama at Birmingham School of Medicine, Birmingham, AL, USA

    Tiffany L. Carson

  5. Department of Epidemiology and Biostatistics, SUNY Downstate Health Sciences University School of Public Health, Brooklyn, NY, USA

    Kitaw Demissie

  6. Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA

    Chi-Chen Hong

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  1. Cathleen Y. Xing
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  2. Michelle Doose
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  3. Bo Qin
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  9. Elisa V. Bandera
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  10. Adana A. M. Llanos
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Correspondence to Adana A. M. Llanos.

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Xing, C.Y., Doose, M., Qin, B. et al. Pre-diagnostic allostatic load and health-related quality of life in a cohort of Black breast cancer survivors. Breast Cancer Res Treat 184, 901–914 (2020). https://doi.org/10.1007/s10549-020-05901-1

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