Breast Cancer Survivorship: 10 Years Later

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DESCRIPTION (provided by applicant): In 1993-1995, we enrolled 364 women with early stage breast cancer into a study, 312 of whom agreed to be randomized to a psychosocial group intervention: education, peer discussion, education + peer discussion, control. The education group had significant benefits to mental and physical functioning, some of which lasted 4 years. No benefits of peer discussion have been documented. In 1998, we began a case-control study of these women as they reached their 5-year survivorship mark. This study is notable for the rigorous control group employed (neighborhood controls) and the wide array of quality of life indices assessed. We found few differences in quality of life between cases and controls, consistent with other recent findings, with the exception of physical functioning. Survivors had worse functioning than controls. We would like to conduct one final in-person interview with these women as they reach their 10-year survivorship mark. Research on survivorship is lacking in general, and there is very little research on 10-year survivors. The goals of the study are: (1) to investigate the positive aspects of the cancer experience with a series of open-ended and close-ended questions on benefit-finding; (2) to describe how survivorship is integrated into women's self-concepts and examine the implications of the survivor self-concept for quality of life; (3) to evaluate changes in quality of life over the 10 years and to discriminate women who are adjusting well in the long-term from those who are having continued difficulties, and (4) to evaluate the research study, including the intervention. We wilt conduct in-person interviews with survivors and significant others to address the issues of benefit-finding and survivor self-concept. We will measure quality of life broadly, identify trajectories of quality of life over the 10 years, and discriminate among the different patterns of change. Finally, we will conduct focus groups with women to examine the positive and negative aspects of their experience with the research study.