Annals of Behavioral Medicine

, Volume 28, Issue 1, pp 39–51

Health-related quality of life in a multiethnic sample of breast cancer survivors

  • Antoinette S. Giedzinska
  • Beth E. Meyerowitz
  • Patricia A. Ganz
  • Julia H. Rowland


Background: Little is known about the experiences of women from varying ethnic groups following treatment for breast cancer.Purpose: This study provides a comprehensive description of heath-related quality of life (HRQL) and identifies problem areas and predictive factors for a multiethnic sample.Methods: Six hundred twenty-one breast cancer survivors from 2 major cities participated within 5 years of their diagnosis. Participants were African Americans, Latinas, Asian Americans, and Whites. Patients filled out questionnaire packets comprising standardized instruments related to HRQL, psychological adjustment, cancer-related treatment, and demographic variables. Data were analyzed using 2 methods: (a) observation of findings prior to controlling for demographic and treatment variables and (b) observation of findings after controlling for variables confounded with ethnicity.Results: Findings indicate that most women experienced good HRQL. Group differences revealed that African Americans found more meaning in life as a result of having breast cancer, and Latinas reported more physical symptoms. Age predicted aspects of HRQL for African Americans and Whites.Conclusions: This study comprehensively assessed HRQL following breast cancer for ethnic minority women. Most breast cancer survivors in this study reported levels of HRQL comparable to established norms. However, some quality of life impediments surfaced in particular groups. Researchers should not assume that predictive models of breast cancer HRQL are the same across ethnic groups.


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  1. (1).
    Meyerowitz BE, Richardson J, Hudson S, Leedham B: Ethnicity and cancer outcomes: Behavioral and psychosocial considerations.Psychological Bulletin. 1998,123:47–70.PubMedCrossRefGoogle Scholar
  2. (2).
    Whitfield KE, Weidner G, Clark R, Anderson NB: Sociodemographic diversity and behavioral medicine.Journal of Consulting and Clinical Psychology. 2002,70:463–481.PubMedCrossRefGoogle Scholar
  3. (3).
    American Cancer Society:Cancer Facts and Figures—2000. Atlanta, GA: Author, 2000.Google Scholar
  4. (4).
    Ashing-Giwa K: Quality of life and psychosocial outcomes in long-term survivors of breast cancer: A focus on African-American women.Journal of Psychosocial Oncology. 1999,17(3/4):47–62.CrossRefGoogle Scholar
  5. (5).
    Gotay CC, Holup JL, Pagano I: Ethnic differences in quality of life among early breast and prostate cancer survivors.Psycho-Oncology. 2002,11:103–113.PubMedCrossRefGoogle Scholar
  6. (6).
    Northouse LL, Caffey M, Deichelbohrer L, et al.: The quality of life of African American women with breast cancer.Research in Nursing and Health. 1999,22:449–460.PubMedCrossRefGoogle Scholar
  7. (7).
    Ashing-Giwa K, Ganz PA, Petersen L: Quality of life of African-American and White long term breast carcinoma survivors.Cancer. 1999,85:418–426.PubMedCrossRefGoogle Scholar
  8. (8).
    Bourjolly JN, Kerson TS, Nuamah IF: A comparison of social functioning among Black and White women with breast cancer.Social Work in Health Care. 1999,28(3):1–20.PubMedCrossRefGoogle Scholar
  9. (9).
    Wyatt GE, Desmond KA, Ganz PA, et al.: Sexual functioning and intimacy in African American and White breast cancer survivors: A descriptive study.Women’s Health: Research on Gender, Behavior, and Policy. 1998,4: 385–405.Google Scholar
  10. (10).
    Spencer SM, Lehman JM, Wynings C, et al.: Concerns about breast cancer and relations to psychosocial well-being in a multiethnic sample of early-stage patients.Health Psychology. 1999,18:159–168.PubMedCrossRefGoogle Scholar
  11. (11).
    Baquet CR, Commiskey P: Socioeconomic factors and breast carcinoma in multicultural women.Cancer. 2000,88:1256–1264.PubMedCrossRefGoogle Scholar
  12. (12).
    Schag CAC, Ganz PA, Polinsky ML, et al.: Characteristics of women at risk for psychosocial distress in the year after breast cancer.Journal of Clinical Oncology. 1993,11:783–793.PubMedGoogle Scholar
  13. (13).
    Brinton LA, Benichou J, Gammon MD, et al.: Ethnicity and variation in breast cancer incidence.International Journal of Cancer. 1997,73:349–355.CrossRefGoogle Scholar
  14. (14).
    Biffl WL, Myers A, Franciose RJ, Gonzalez RJ, Darnell D: Is breast cancer in young Latinas a different disease?American Journal of Surgery. 2001,182:596–600.PubMedCrossRefGoogle Scholar
  15. (15).
    Siegel K, Gluhoski V, Gorey E: Age-related distress among young women with breast cancer.Journal of Psychosocial Oncology. 1999,17:1–20.CrossRefGoogle Scholar
  16. (16).
    Wenzel LB, Fairclough DL, Brady MJ, et al.: Age-related differences in the quality of life of breast carcinoma patients after treatment.Cancer. 1999,86:1768–1774.PubMedCrossRefGoogle Scholar
  17. (17).
    Muss HB, Hunter CP, Wesley M, et al.: Treatment plans for Black and White women with Stage II node-positive breast cancer: The National Cancer Institute Black/White Cancer Survival Study experience.Cancer. 1992,70:2460–2467.PubMedCrossRefGoogle Scholar
  18. (18).
    Lee MM, Lin SS, Wrensch MR, Adler SR, Eisenberg D: Alternative therapies used by women with breast cancer in four ethnic populations.Journal of the National Cancer Institute. 2000,92:42–47.PubMedCrossRefGoogle Scholar
  19. (19).
    Ganz PA, Schag CAC, Lee JJ, Polinsky ML, Tan SJ: Breast conservation versus mastectomy: Is there a difference in psychological adjustment or quality of life in the year after surgery?Cancer. 1992,69:1729–1738.PubMedCrossRefGoogle Scholar
  20. (20).
    Ganz PA, Rowland JH, Desmond K, Meyerowitz BE, Wyatt GE: Life after breast cancer: Understandingwomen’s health-related quality of life and sexual functioning.Journal of Clinical Oncology. 1998,16: 501–514.PubMedGoogle Scholar
  21. (21).
    Ganz PA, Desmond K, Belin TR, Meyerowitz BE, Rowland JH: Predictors of sexual health in women after a breast cancer diagnosis.Journal of Clinical Oncology. 1999,17:2371–2380.PubMedGoogle Scholar
  22. (22).
    Hays RD, Sherbourne CD, Mazel RM: The RAND 36-Item Health Survey 1.0.Health Economics. 1993,2:217–227.PubMedCrossRefGoogle Scholar
  23. (23).
    Schag CC, Heinrich RL, Ganz PA: Cancer inventory of problem situations: An instrument for assessing cancer patients’rehabilitation needs.Journal of Psychosocial Oncology. 1983,1:11–24.CrossRefGoogle Scholar
  24. (24).
    Ganz PA, Day R,Ware Jr. JE, Redmond C, Fisher B: Base-line quality of life assessment in the National Surgical Adjuvant Breast and Bowel Project Cancer Prevention trial.Journal of the National Cancer Institute. 1995,87:1372–1382.PubMedCrossRefGoogle Scholar
  25. (25).
    Bower JE, Meyerowitz BE, Desmond KA, et al.: Perceptions of positive meaning and vulnerability following breast cancer.Unpublished manuscript.Google Scholar
  26. (26).
    Tedeschi RG, Calhoun LG: The Posttraumatic Growth Inventory: Measuring the positive legacy of trauma.Journal of Traumatic Stress. 1996,9:455–472.PubMedCrossRefGoogle Scholar
  27. (27).
    Radloff LS: The CES-D scale: A self-report depression scale for research in the general population.Applied Psychological Measurement. 1977,1:385–401.CrossRefGoogle Scholar
  28. (28).
    Stewart AL, Ware Jr. JE, Sherbourne CD, Wells KB: Psychological distress/well-being and cognitive functioning measures. In Stewart AL, Ware Jr. JE (eds),Measuring Functioning and Well-Being: The Medical Outcomes Study Approach. Durham, NC: Duke University Press, 1992, 102–142.Google Scholar
  29. (29).
    Veit CT, Ware Jr. JE: The structure of psychological distress and well-being in the general population.Journal of Consulting and Clinical Psychology. 1983,51:730–742.PubMedCrossRefGoogle Scholar
  30. (30).
    Sherbourne CD, Stewart AL: The MOS social support survey.Social Science Medicine. 1991,32:705–714.PubMedCrossRefGoogle Scholar
  31. (31).
    Spanier GB: Measuring dyadic adjustment: New scales for assessing the quality of marriage and similar dyads.Journal of Marriage and the Family. 1976,398:15–28.CrossRefGoogle Scholar
  32. (32).
    Busby DM, Crane DR, Larson JH: A revision of the Dyadic Adjustment Scale for use with distressed and nondistressed couples: Construct hierarchy and multidimensional scales.Journal of Marital and Family Therapy. 1995,21:289–308.CrossRefGoogle Scholar
  33. (33).
    Hays WH:Statistics (3rd Ed.) Fort Worth, TX: Harcourt Brace College, 1994.Google Scholar
  34. (34).
    Pedhazur EJ:Multiple Regression in Behavioral Research (3rd Ed.). Fort Worth, TX: Harcourt Brace College, 1997.Google Scholar
  35. (35).
    Ware Jr. JE:SF-36 Health Survey: Manual and Interpretation Guide. Boston: Health Institute, New England Medical Center, 1993.Google Scholar
  36. (36).
    Kaplan MS, Marks G: Adverse effects of acculturation: Psychological distress among Mexican American young adults.Social Science and Medicine. 1990,31:1313–1319.PubMedCrossRefGoogle Scholar
  37. (37).
    Meyerowitz BE, Formenti SC, Ell KO, Leedham B: Depression among Latina cervical cancer patients.Journal of Social and Clinical Psychology. 2000,19:352–371.Google Scholar
  38. (38).
    Schover LR, Yetman RJ, Tuason LJ: Partial mastectomy and breast reconstruction: A comparison of their effects on psychosocial adjustment, body image, and sexuality.Cancer. 1995,75:54–64.PubMedCrossRefGoogle Scholar

Copyright information

© The Society of Behavioral Medicine 2004

Authors and Affiliations

  • Antoinette S. Giedzinska
    • 1
  • Beth E. Meyerowitz
    • 1
  • Patricia A. Ganz
    • 2
  • Julia H. Rowland
    • 3
  1. 1.Department of PsychologyUniversity of Southern CaliforniaLos Angeles
  2. 2.University of CaliforniaLos Angeles
  3. 3.National Institutes of HealthNational Cancer InstituteUSA

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