title: Social support and its implications in older, early-stage breast cancer patients in CALGB 49907 (Alliance A171301).
abstract: BACKGROUND
  Studies point to a direct association between social support and better cancer outcomes. This study examined whether baseline social support is associated with better survival and fewer chemotherapy-related adverse events in older, early-stage breast cancer patients.
  
  
  METHODS
  This study is a pre-planned secondary analysis of CALGB 49907/Alliance A171301, a randomized trial that compared standard adjuvant chemotherapy versus capecitabine in breast cancer patients 65 years of age or older. A subset reported on the extent of their social support with questionnaires that were completed 6 times over 2 years.
  
  
  RESULTS
  The median age of this 331-patient cohort was 72 years (range: 65, 90); 179 (55%) were married, and 210 (65%) lived with someone. One hundred forty-five patients (46%) described a social network of 0-10 people; 110 (35%) of 11-25; and 58 (19%) of 26 or more. The Medical Outcomes Study (MOS) social support survey revealed that the median scores (range) for emotional/informational, tangible, positive social interaction, and affectionate social support were 94 (3, 100), 94 (0, 100), 96 (0, 100), and 100 (8, 100), respectively. Social support scores appeared stable over 2 years and higher (more support) than in other cancer settings. No statistically significant associations were observed between social support and survival and adverse events in multivariate analyses. However, married patients had smaller tumors, and those with arthritis reported less social support.
  
  
  CONCLUSIONS
  Although social support did not predict survival and adverse events, the exploratory but plausible inverse associations with larger tumors and arthritis suggest that social support merits further study.
authors.affiliation: Department of Oncology, Mayo Clinic, Rochester, MN, USA.
authors.forename: Aminah
authors.initials: A
authors.lastname: Jatoi
authors.affiliation: University of North Carolina at Chapel Hill, Lineberger Comprehensive Cancer Center, Chapel Hill, NC, USA.
authors.forename: Hyman
authors.initials: H
authors.lastname: Muss
authors.affiliation: Alliance Statistics and Data Center, Mayo Clinic, Rochester, MN, USA.
authors.forename: Jake B
authors.initials: JB
authors.lastname: Allred
authors.affiliation: Department of Medicine and Center for the Study of Aging and Human Development, Duke University, Durham, NC, USA.
authors.forename: Harvey J
authors.initials: HJ
authors.lastname: Cohen
authors.affiliation: Alliance Statistics and Data Center, Mayo Clinic, Rochester, MN, USA.
authors.forename: Karla
authors.initials: K
authors.lastname: Ballman
authors.affiliation: Novant Health Oncology Specialists, Winston Salem, NC, USA.
authors.forename: Judith O
authors.initials: JO
authors.lastname: Hopkins
authors.affiliation: Department of Medicine, State University of New York Upstate Medical University, Syracuse, NY, USA.
authors.forename: Ajeet
authors.initials: A
authors.lastname: Gajra
authors.affiliation: Cancer Center Clinical Research Offices, Mayo Clinic, Rochester, MN, USA.
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Lafky
authors.affiliation: Department of Oncology, Johns Hopkins University, Baltimore, MD, USA.
authors.forename: Antonio
authors.initials: A
authors.lastname: Wolff
authors.affiliation: Department of Oncology, Mayo Clinic, Rochester, MN, USA.
authors.forename: Lisa
authors.initials: L
authors.lastname: Kottschade
authors.affiliation: Division of Medical Oncology, University of Washington, Seattle, WA, USA.
authors.forename: Julie
authors.initials: J
authors.lastname: Gralow
authors.affiliation: City of Hope, Duarte, CA, USA.
authors.forename: Arti
authors.initials: A
authors.lastname: Hurria
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000523:psychology*; D000069287:Capecitabine / Q000627:therapeutic use*; D017024:Chemotherapy, Adjuvant / Q000379:methods*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D017063:Outcome Assessment, Health Care; D012944:Social Support; D011795:Surveys and Questionnaires; D016019:Survival Analysis; D013997:Time Factors
chemical_list: D000069287:Capecitabine
keywords: breast cancer; cancer; older patients; oncology; social support