title: Breast cancer survivors of different sexual orientations: which factors explain survivors' quality of life and adjustment?
abstract: BACKGROUND
  Little is known about differences by sexual orientation in explanatory factors of breast cancer survivors' quality of life, anxiety, and depression.
  
  
  METHODS
  Survivors were recruited from a cancer registry and additional survivors recruited through convenience methods. Data were collected via telephone survey from all 438 survivors, who were disease free and diagnosed with non-metastatic breast cancer an average of 5 years earlier. To explain quality of life, anxiety, and depression, we focused on sexual orientation as the primary independent factors, in addition, considering demographic, psychosocial, clinical, and functional factors as correlates.
  
  
  RESULTS
  Sexual orientation had indirect associations with each of the outcomes, through disease-related and demographic factors as well as psychosocial and coping resources. The various explanatory models explain between 36% and 50% of the variance in outcomes and identified areas of strengths and vulnerabilities in sexual minority compared with heterosexual survivors.
  
  
  CONCLUSIONS
  This study's findings of strengths among specific subgroups of sexual minority compared with heterosexual survivors require further explorations to identify the reasons for this finding. Most of the identified vulnerabilities among sexual minority compared with heterosexual survivors of breast cancer are amenable to change by interventions.
authors: Department of Community Health Sciences, Boston University, School of Public Health, Boston, MA 02118, USA. boehmer@bu.edu
authors: U
authors: U
authors: Boehmer
authors: M
authors: M
authors: Glickman
authors: M
authors: M
authors: Winter
authors: M A
authors: MA
authors: Clark
mesh_terms: D000223:Adaptation, Psychological; D000368:Aged; D001943:Breast Neoplasms / Q000453:epidemiology / Q000523:psychology*; D003625:Data Collection / Q000379:methods; D005260:Female; D020010:Heterosexuality / Q000523:psychology; D018452:Homosexuality, Female / Q000523:psychology; D006801:Humans; D008875:Middle Aged; D011788:Quality of Life / Q000523:psychology*; D012042:Registries; D012725:Sexual Behavior / Q000523:psychology*; D012917:Social Adjustment; D017741:Survivors / Q000523:psychology*
keywords: anxiety; breast cancer; depression; female; homosexuality; quality of life; survivorship