title: Social networks and health-related quality of life in breast cancer survivors: a prospective study.
abstract: OBJECTIVE
  To examine prospectively the influence of social networks on health-related quality of life (HRQoL) among breast cancer survivors.
  
  
  METHODS
  Social networks and HRQoL were assessed among women free of breast cancer in the Nurses' Health Study (NHS). Women who developed breast cancer over a 4-year follow-up (n=708) completed detailed questions related to treatment together with an assessment of general and cancer-specific HRQoL.
  
  
  RESULTS
  On average, socially isolated women were more adversely affected by breast cancer--their role function was lower by 14 points, vitality lower by 7 points, and physical function lower by 6 points compared to the most socially integrated women.
  
  
  CONCLUSIONS
  Prediagnosis level of social integration is an important factor in future HRQoL among breast cancer survivors, and appears to explain more of the variance in HRQoL than treatment or tumor characteristics. Rehabilitation programs should incorporate interventions that address the availability of adequate social support among breast cancer survivors.
authors.affiliation: School of Community Health, College of Urban and Public Affairs, Portland State University, PO Box 751, OR 97207, USA. michaely@pdx.edu
authors.forename: Yvonne L
authors.initials: YL
authors.lastname: Michael
authors.forename: Lisa F
authors.initials: LF
authors.lastname: Berkman
authors.forename: Graham A
authors.initials: GA
authors.lastname: Colditz
authors.forename: Michelle D
authors.initials: MD
authors.lastname: Holmes
authors.forename: Ichiro
authors.initials: I
authors.lastname: Kawachi
mesh_terms: D000368:Aged; D001943:Breast Neoplasms / Q000150:complications / Q000473:pathology / Q000523:psychology*; D005260:Female; D006304:Health Status; D006801:Humans; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life; D012944:Social Support