Older breast cancer survivors: factors associated with change in emotional well-being.

PURPOSE During the 5 years after primary breast cancer diagnosis for women 65 years old, we examined factors associated with change in emotional well-being. PATIENTS AND METHODS We identified women diagnosed with primary breast cancer and selected women with stage I to IIIa disease, age 65 years, and for whom we had permission from the attending physician to contact. Data were collected during 5 years of follow-up from consenting patients' medical records and telephone interviews with patients. Outcomes included a five-question Mental Health Inventory general measure of emotional health (MHI5) and two cancer-specific measures: breast cancer-specific emotional health (BCSEH) and Cancer Rehabilitation Evaluation System-Short Form (CARES-SF) Psychosocial Summary Scale. RESULTS During 5 years of follow-up of older breast cancer survivors, 57% had less than a +/- 10-point change in MHI5, 38% had less than a +/- 10-point change in BCSEH, and 52% had less than a +/- 10-point change in CARES-SF Psychosocial Summary Scale. Women with less than 12 years of education were at greatest risk for having negative changes in both general and breast cancer-specific emotional health. Moreover, we also found that women who perceived themselves as never being cured had greater negative changes in all outcomes. Conversely, those who had better physical function, emotional social support, and positive ratings regarding the quality of medical interactions at baseline were less likely to have poor emotional health during follow-up. CONCLUSION For the majority of older breast cancer survivors, cancer-specific well-being and general emotional health do not change substantially after a breast cancer diagnosis. Among those in whom change occurs, risk factors are similar and may be related to other age-related diseases.