Child maltreatment and breast cancer survivors: Social support makes a difference for quality of life, fatigue and cancer stress

https://doi.org/10.1016/j.ejca.2011.06.022Get rights and content

Abstract

Purpose

To identify how child maltreatment is associated with quality of life (QOL) among breast cancer survivors.

Patients and methods

One hundred and thirty two women who had completed treatment for stage 0-IIIA breast cancer within the past 2 years (except for tamoxifen/aromatase inhibitors) and were at least 2 months post surgery, radiation, or chemotherapy completed questionnaires including the Childhood Trauma Questionnaire, the Impact of Events Scale, the Multidimensional Fatigue Symptom Inventory-Short Form (MFSI-SF) and the Fact-B breast cancer quality of life questionnaire.

Results

Women who were abused or neglected as children reported more cancer-related psychological distress, more fatigue and poorer physical, emotional, functional and breast cancer-specific well-being after treatment. These relations were partially explained by the fact that breast cancer survivors reported receiving less support as adults.

Conclusion

The findings suggest that child maltreatment is an important predictor of QOL among breast cancer survivors. One reason why this association exists is because those who are maltreated as children report less support as adults. A better understanding of how child maltreatment contributes to breast cancer survivor QOL will help in tailoring and, therefore, enhancing the efficacy of interventions aimed at improving QOL.

Section snippets

Participants

The study data were drawn from the baseline sample of 132 women who participated in a clinical trial addressing the potential benefits of yoga for breast cancer survivors. Participants were recruited through breast cancer clinics and media announcements. Eligible women had completed treatment for stage 0-IIIA breast cancer within the past 2 years (except for tamoxifen/aromatase inhibitors) and were at least 2 months post surgery, radiation or chemotherapy (whichever occurred last). Screening

Results

Table 1 reports descriptive information for all participants. Almost half (48%) of our sample had at least one form of maltreatment, consistent with the broader literature on child abuse and neglect.8 Maltreated and non-maltreated participants did not differ by treatment type, cancer stage, time since diagnosis, time since last treatment or age. Less than 5% of our sample had any Charlson-rated comorbidities other than their breast cancer diagnosis, and thus we did not control for them in our

Discussion

With more women surviving breast cancer, health professionals have focused on why some breast cancer survivors are more vulnerable to poorer post-treatment QOL than others.34 The current study examined relationships between child maltreatment and QOL among breast cancer survivors. Those who were abused or neglected as children experienced more cancer-specific psychological distress, more fatigue, and poorer physical, emotional, functional and breast cancer specific well-being after treatment.

Conflict of interest statement

None declared.

Acknowledgements

Work on this paper was supported in part by NIH grants R01CA126857, R01CA131029, NCRR Grant UL1RR025755, which funds the Clinical Research Center, the Ohio State Comprehensive Cancer Center Core Grant CA16058, and an American Cancer Society Postdoctoral Fellowship Grant PF-11-007-01-CPPB awarded to the first author. We appreciate the helpful assistance of Heather Preston, Jeanette Bennett, Cathie Atkinson, Lindsay Madaras, and Mary Lower.

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