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Coping strategies and anxiety in young breast cancer survivors

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Abstract

Purpose

We sought to describe coping strategies reported by young breast cancer survivors and evaluate the relationship between utilization of specific coping strategies and anxiety in survivorship.

Methods

Participants enrolled in The Young Women’s Breast Cancer Study, a multi-center, cohort of women diagnosed with breast cancer at age ≤ 40 years, completed surveys that assessed demographics, coping strategies (reported at 6-month post-enrollment and 18-month post-diagnosis), and anxiety (2 years post-diagnosis). We used univariable and multivariable logistic regression to examine the relationship between coping strategies and anxiety.

Results

A total of 833 women with stage 0–3 breast cancer were included in the analysis; median age at diagnosis was 37 (range: 17–40) years. Social supports were the most commonly reported coping strategies, with the majority reporting moderate or greater use of emotional support from a partner (90%), parents (78%), other family (79%), and reliance on friends (88%) at both 6 and 18 months. In multivariable analyses, those with moderate or greater reliance on emotional support from other family (odds ratio (OR): 0.37, 95% confidence ratio (CI): 0.22–0.63) at 18 months were less likely to have anxiety at 2 years, while those with moderate or greater reliance on alcohol/drug use (OR: 1.83, 95%CI: 1.12–3.00) and taking care of others (OR: 1.90, 95%CI: 1.04–3.45) to cope were more likely to have anxiety.

Conclusion

Young breast cancer survivors rely heavily on support from family and friends. Our findings underscore the importance of considering patients’ social networks when developing interventions targeting coping in survivorship.

Clinical trial registration number

NCT01468246 (first posted November 9, 2011).

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Data availability

The data are not publicly available as the Institutional Review Board Committee (IRB)-approved research protocol specified that all data must be collected, coded, and stored at the Dana-Farber Cancer Institute and be limited-access and password-protected, in order to protect the identity of respondents. Requests can be made to share data privately. However, any data sharing will require a formal data transfer agreement between the Dana-Farber Cancer Institute and the other party. Requests to this effect should be directed to the corresponding author.

References

  1. Johnson RH, Anders CK, Litton JK, Ruddy KJ, Bleyer A (2018) Breast cancer in adolescents and young adults. Pediatr Blood Cancer 65(12):e27397. https://doi.org/10.1002/pbc.27397

    Article  PubMed  Google Scholar 

  2. Miller KD, Fidler-Benaoudia M, Keegan TH, Hipp HS, Jemal A (2020) Siegel RL (2020) Cancer statistics for adolescents and young adults. CA Cancer J Clin 70(6):443–459. https://doi.org/10.3322/caac.21637

    Article  PubMed  Google Scholar 

  3. Stone DS, Ganz PA, Pavlish C, Robbins WA (2017) Young adult cancer survivors and work: a systematic review. J Cancer Survivorship : Res Pract 11(6):765–781. https://doi.org/10.1007/s11764-017-0614-3

    Article  Google Scholar 

  4. Cathcart-Rake EJ, Ruddy KJ, Bleyer A, Johnson RH (2021) Breast cancer in adolescent and young adult women under the age of 40 years. JCO Oncol Pract 17(6):305–313. https://doi.org/10.1200/OP.20.00793

    Article  PubMed  Google Scholar 

  5. Northouse LL (1994) Breast cancer in younger women: effects on interpersonal and family relations. J Natl Cancer Inst Monogr 16:183–190

    Google Scholar 

  6. Gould J, Grassau P, Manthorne J, Gray RE, Fitch MI (2006) “Nothing fit me”: nationwide consultations with young women with breast cancer. Health Expect 9(2):158–173. https://doi.org/10.1111/j.1369-7625.2006.00383.x

    Article  PubMed  PubMed Central  Google Scholar 

  7. Abdelhadi OA, Pollock BH, Joseph JG, Keegan THM (2022) Psychological distress and associated additional medical expenditures in adolescent and young adult cancer survivors. Cancer 128(7):1523–1531. https://doi.org/10.1002/cncr.34064

    Article  PubMed  Google Scholar 

  8. Harris J, Cornelius V, Ream E, Cheevers K, Armes J (2017) Anxiety after completion of treatment for early-stage breast cancer: a systematic review to identify candidate predictors and evaluate multivariable model development. Support Care Cancer 25(7):2321–2333. https://doi.org/10.1007/s00520-017-3688-6

    Article  PubMed  PubMed Central  Google Scholar 

  9. Berg CJ, Stratton E, Esiashvili N, Mertens A (2016) Young adult cancer survivors’ experience with cancer treatment and follow-up care and perceptions of barriers to engaging in recommended care. J Cancer Educ 31(3):430–442. https://doi.org/10.1007/s13187-015-0853-9

    Article  PubMed  PubMed Central  Google Scholar 

  10. Geyer S, Koch-Giesselmann H, Noeres D (2015) Coping with breast cancer and relapse: Stability of coping and long-term outcomes in an observational study over 10 years. Soc Sci Med 135:92–98. https://doi.org/10.1016/j.socscimed.2015.04.027

    Article  PubMed  Google Scholar 

  11. Zamanian H, Amini-Tehrani M, Jalali Z, Daryaafzoon M, Ala S, Tabrizian S, Foroozanfar S (2021) Perceived social support, coping strategies, anxiety and depression among women with breast cancer: evaluation of a mediation model. Eur J Oncol Nurs 50:101892. https://doi.org/10.1016/j.ejon.2020.101892

    Article  PubMed  Google Scholar 

  12. Manuel JC, Burwell SR, Crawford SL, Lawrence RH, Farmer DF, Hege A, Phillips K, Avis NE (2007) Younger women’s perceptions of coping with breast cancer. Cancer Nurs 30(2):85–94. https://doi.org/10.1097/01.NCC.0000265001.72064.dd

    Article  PubMed  Google Scholar 

  13. Lauver DR, Connolly-Nelson K, Vang P (2007) Stressors and coping strategies among female cancer survivors after treatments. Cancer Nurs 30(2):101–111. https://doi.org/10.1097/01.NCC.0000265003.56817.2c

    Article  PubMed  Google Scholar 

  14. Gierisch JM, Earp JA, Brewer NT, Rimer BK (2010) Longitudinal predictors of nonadherence to maintenance of mammography. Cancer Epidemiol Biomark Prev 19(4):1103–1111. https://doi.org/10.1158/1055-9965.EPI-09-1120

    Article  Google Scholar 

  15. Williams RB, Barefoot JC, Califf RM, Haney TL, Saunders WB, Pryor DB, Hlatky MA, Siegler IC, Mark DB (1992) Prognostic importance of social and economic resources among medically treated patients with angiographically documented coronary artery disease. JAMA 267(4):520–524

    Article  CAS  PubMed  Google Scholar 

  16. Zigmond AS, Snaith RP (1983) The hospital anxiety and depression scale. Acta Psychiatr Scand 67(6):361–370. https://doi.org/10.1111/j.1600-0447.1983.tb09716.x

    Article  CAS  PubMed  Google Scholar 

  17. Bjelland I, Dahl AA, Haug TT, Neckelmann D (2002) The validity of the Hospital Anxiety and Depression Scale. An updated literature review. J Psychosom Res 52(2):69–77. https://doi.org/10.1016/s0022-3999(01)00296-3

    Article  PubMed  Google Scholar 

  18. Lopez G, Liu W, Madden K, Fellman B, Li Y, Bruera E (2018) Adolescent-young adults (AYA) with cancer seeking integrative oncology consultations: demographics, characteristics, and self-reported outcomes. Support Care Cancer 26(4):1161–1167. https://doi.org/10.1007/s00520-017-3937-8

    Article  PubMed  Google Scholar 

  19. Burstein HJ, Gelber S, Guadagnoli E, Weeks JC (1999) Use of alternative medicine by women with early-stage breast cancer. N Engl J Med 340(22):1733–1739. https://doi.org/10.1056/NEJM199906033402206

    Article  CAS  PubMed  Google Scholar 

  20. Lee MK, Yun YH, Park HA, Lee ES, Jung KH, Noh DY (2014) A Web-based self-management exercise and diet intervention for breast cancer survivors: pilot randomized controlled trial. Int J Nurs Stud 51(12):1557–1567. https://doi.org/10.1016/j.ijnurstu.2014.04.012

    Article  PubMed  Google Scholar 

  21. Kushner MG, Abrams K, Borchardt C (2000) The relationship between anxiety disorders and alcohol use disorders: a review of major perspectives and findings. Clin Psychol Rev 20(2):149–171. https://doi.org/10.1016/s0272-7358(99)00027-6

    Article  CAS  PubMed  Google Scholar 

  22. Borstelmann NA, Rosenberg SM, Ruddy KJ, Tamimi RM, Gelber S, Schapira L, Come S, Borges V, Morgan E, Partridge AH (2015) Partner support and anxiety in young women with breast cancer. Psychooncology 24(12):1679–1685. https://doi.org/10.1002/pon.3780

    Article  PubMed  Google Scholar 

  23. Smith JP, Randall CL (2012) Anxiety and alcohol use disorders: comorbidity and treatment considerations. Alcohol Res 34(4):414–431

    PubMed  PubMed Central  Google Scholar 

  24. Kwan ML, Kushi LH, Weltzien E, Tam EK, Castillo A, Sweeney C, Caan BJ (2010) Alcohol consumption and breast cancer recurrence and survival among women with early-stage breast cancer: the life after cancer epidemiology study. J Clin Oncol 28(29):4410–4416. https://doi.org/10.1200/JCO.2010.29.2730

    Article  PubMed  PubMed Central  Google Scholar 

  25. Chen WY, Rosner B, Hankinson SE, Colditz GA, Willett WC (2011) Moderate alcohol consumption during adult life, drinking patterns, and breast cancer risk. JAMA 306(17):1884–1890. https://doi.org/10.1001/jama.2011.1590

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  26. Naerde A, Tambs K, Mathiesen KS, Dalgard OS, Samuelsen SO (2000) Symptoms of anxiety and depression among mothers of pre-school children: effect of chronic strain related to children and child care-taking. J Affect Disord 58(3):181–199. https://doi.org/10.1016/s0165-0327(99)00119-6

    Article  CAS  PubMed  Google Scholar 

  27. Barnes J, Kroll L, Burke O, Lee J, Jones A, Stein A (2000) Qualitative interview study of communication between parents and children about maternal breast cancer. BMJ 321(7259):479–482. https://doi.org/10.1136/bmj.321.7259.479

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  28. Lyman GH, Greenlee H, Bohlke K, Bao T, DeMichele AM, Deng GE, Fouladbakhsh JM, Gil B, Hershman DL, Mansfield S, Mussallem DM, Mustian KM, Price E, Rafte S, Cohen L (2018) Integrative therapies during and after breast cancer treatment: ASCO Endorsement of the SIO Clinical Practice Guideline. J Clin Oncol 36(25):2647–2655. https://doi.org/10.1200/JCO.2018.79.2721

    Article  CAS  PubMed  Google Scholar 

  29. MoghaddamTabrizi F, Alizadeh S (2018) Family intervention based on the FOCUS program effects on cancer coping in iranian breast cancer patients: a randomized control trial. Asian Pac J Cancer Prev 19(6):1523–1528. https://doi.org/10.22034/APJCP.2018.19.6.1523

    Article  Google Scholar 

  30. Cheung EO, Cohn MA, Dunn LB, Melisko ME, Morgan S, Penedo FJ, Salsman JM, Shumay DM, Moskowitz JT (2017) A randomized pilot trial of a positive affect skill intervention (lessons in linking affect and coping) for women with metastatic breast cancer. Psychooncology 26(12):2101–2108. https://doi.org/10.1002/pon.4312

    Article  PubMed  Google Scholar 

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Acknowledgements

The authors wish to thank Valerie Hope Goldstein for editorial and submission assistance.

Funding

This research was supported by Susan G. Komen (Partridge), the Breast Cancer Research Foundation (Partridge), the Agency for Healthcare Research and Quality K01HS023680 (Rosenberg), and the Harvard Kennedy School Center for Public Leadership’s Zuckerman Fellowship (Krasne). The funding agreement ensured the authors’ independence in designing the study, interpreting the data, writing, and publishing the report.

Author information

Author notes

  1. Shoshana M. Rosenberg

    Present address: Weill Cornell Medicine, New York, NY, USA

Authors and Affiliations

  1. Johns Hopkins Hospital, Baltimore, MD, USA

    Margaret Krasne

  2. Mayo Clinic, Rochester, MN, USA

    Kathryn J. Ruddy

  3. Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA

    Philip D. Poorvu, Shari I. Gelber, Ann H. Partridge & Shoshana M. Rosenberg

  4. Breast Oncology Program, Dana-Farber Brigham Cancer Center, Boston, MA, USA

    Philip D. Poorvu, Shari I. Gelber, Ann H. Partridge & Shoshana M. Rosenberg

  5. Harvard Medical School, Boston, MA, USA

    Philip D. Poorvu, Ann H. Partridge & Shoshana M. Rosenberg

  6. Department of Population Health Sciences, Weill Cornell Medicine, 402 E 67th St LA-0005, New York, NY, 10065, USA

    Rulla M. Tamimi & Shoshana M. Rosenberg

  7. Stanford Cancer Institute, Palo Alto, CA, USA

    Lidia Schapira

  8. Massachusetts General Hospital, Boston, MA, USA

    Jeffrey Peppercorn

  9. Beth Israel Deaconess Medical Center, Boston, MA, USA

    Steven E. Come

  10. University of Colorado Cancer Center, Aurora, CO, USA

    Virginia F. Borges

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Contributions

M.K, A.H.P., and S.M.R. provided the initial conceptualization for and writing of the original draft of the manuscript. A.H.P. provided funding acquisition for this study. M.K., S.I.G, A.H.P., R.M.T., and S.M.R. had a significant contribution to the conceptualization of the cohort, methodology, and analysis. All authors contributed to review and editing. M.K. and S.M.R. were responsible for the final manuscript edits.

Corresponding author

Correspondence to Shoshana M. Rosenberg.

Ethics declarations

Ethics approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the IRB. The study was approved by the IRBs of Dana-Farber Harvard Cancer Center, and other participating sites (Beth Israel Deaconess Medical Center, Brigham and Women’s Hospital, Brigham and Women’s Faulkner Hospital, Cape Cod Hospital, Lowell General Hospital, Massachusetts General Hospital, Mayo Clinic, Newton-Wellesley Hospital, North Shore Cancer Center Salem, South Shore Hospital, Sunnybrook Health Sciences Centre, and University of Colorado Hospital).

Consent to participate

Informed consent was obtained from all individuals included in the study.

Competing interests

S.M.R. reports grants from the Agency for Healthcare Research and Quality, during the conduct of the study and current grant funding from Pfizer. R.M.T. reports grants from the NIH/NCI, during the conduct of the study. J.P. reports personal fees from GlaxosmithKline (Spouse, employment), grants from Outcomes4Me Inc, personal fees from Athenex, and personal fees from Abbott Labs, outside the submitted work. A.H.P. receives royalties for co-authoring the Breast Cancer Survivorship section of UpToDate. All other authors declare no competing interests.

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Krasne, M., Ruddy, K.J., Poorvu, P.D. et al. Coping strategies and anxiety in young breast cancer survivors. Support Care Cancer 30, 9109–9116 (2022). https://doi.org/10.1007/s00520-022-07325-7

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