title: Latent class analysis suggests four distinct classes of complementary medicine users among women with breast cancer.
abstract: BACKGROUND
  Breast cancer patients commonly report using >1 form of complementary and alternative medicine (CAM). However, few studies have attempted to analyze predictors and outcomes of multiple CAM modalities. We sought to group breast cancer patients by clusters of type and intensity of complementary and alternative medicine (CAM) use following diagnosis.
  
  
  METHODS
  Detailed CAM use following breast cancer diagnosis was assessed in 2002-2003 among 764 female residents of Long Island, New York diagnosed with breast cancer in 1996-1997. Latent class analysis (LCA) was applied to CAM modalities while taking into account frequency and intensities.
  
  
  RESULTS
  Four distinct latent classes of CAM use emerged: 1) "Low-dose supplement users" (40%), who used only common nutritional supplements; 2) "Vitamin/mineral supplement users" (39%), using an abundance of supplements in addition to other practices; 3) "Mind-body medicine users" (12%), with near-universal use of supplements, mind-body medicine techniques, and massage; and 4) "Multi-modality high-dose users" (9%), who were highly likely to use nearly all types of CAM. Predictors of membership in classes with substantial CAM use included younger age, more education, higher income, Jewish religion, ideal body mass index, higher fruit and vegetable intake, higher levels of physical activity, receipt of adjuvant chemotherapy, and prior use of oral contraceptives.
  
  
  CONCLUSIONS
  LCA identified important subgroups of breast cancer patients characterized by varying degrees of complementary therapy use. Further research should explore the reproducibility of these classes and investigate the association between latent class membership and breast cancer outcomes.
authors.affiliation: Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168th St, New York, NY, USA. gstrizich@gmail.com.
authors.forename: Garrett
authors.initials: G
authors.lastname: Strizich
authors.affiliation: Department of Epidemiology, University of North Carolina, 2101 McGavran-Greenberg Hall, CB #7435, Chapel Hill, NC, USA. gammon@unc.edu.
authors.forename: Marilie D
authors.initials: MD
authors.lastname: Gammon
authors.affiliation: Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168th St, New York, NY, USA. jsj4@columbia.edu.|Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, 161 Fort Washington Ave., New York, NY, USA. jsj4@columbia.edu.
authors.forename: Judith S
authors.initials: JS
authors.lastname: Jacobson
authors.affiliation: Department of Biostatistics, Mailman School of Public Health, Columbia University, 722 West 168th St, New York, NY, USA. mmw2177@columbia.edu.
authors.forename: Melanie
authors.initials: M
authors.lastname: Wall
authors.affiliation: Department of Epidemiology, University of North Carolina, 2101 McGavran-Greenberg Hall, CB #7435, Chapel Hill, NC, USA. salmonbayepid@gmail.com.
authors.forename: Page
authors.initials: P
authors.lastname: Abrahamson
authors.affiliation: Department of Epidemiology, University of North Carolina, 2101 McGavran-Greenberg Hall, CB #7435, Chapel Hill, NC, USA. pbradshaw@berkeley.edu.|Department of Nutrition, University of North Carolina, 2200 McGavran-Greenberg Hall, CB #7461, Chapel Hill, NC, USA. pbradshaw@berkeley.edu.
authors.forename: Patrick T
authors.initials: PT
authors.lastname: Bradshaw
authors.affiliation: Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168th St, New York, NY, USA. mt146@columbia.edu.|Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, 161 Fort Washington Ave., New York, NY, USA. mt146@columbia.edu.
authors.forename: Mary Beth
authors.initials: MB
authors.lastname: Terry
authors.affiliation: Department of Preventive Medicine, Mount Sinai School of Medicine, 17 E 102nd Street, New York, NY, USA. susan.teitelbaum@mssm.edu.
authors.forename: Susan
authors.initials: S
authors.lastname: Teitelbaum
authors.affiliation: Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168th St, New York, NY, USA. ain1@columbia.edu.|Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, 161 Fort Washington Ave., New York, NY, USA. ain1@columbia.edu.|Department of Medicine, College of Physicians and Surgeons, Columbia University, 630 West 168th Street, New York, NY, USA. ain1@columbia.edu.
authors.forename: Alfred I
authors.initials: AI
authors.lastname: Neugut
authors.affiliation: Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168th St, New York, NY, USA. hg2120@columbia.edu.|Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, 161 Fort Washington Ave., New York, NY, USA. hg2120@columbia.edu.|, Present address: 722 W. 168th St., Room 733, New York, NY, 10032, USA. hg2120@columbia.edu.
authors.forename: Heather
authors.initials: H
authors.lastname: Greenlee
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D001943:Breast Neoplasms / Q000628:therapy*; D000529:Complementary Therapies / Q000706:statistics & numerical data*; D019587:Dietary Supplements / Q000706:statistics & numerical data; D004522:Educational Status; D005260:Female; D006801:Humans; D008875:Middle Aged; D026441:Mind-Body Therapies / Q000706:statistics & numerical data; D009518:New York; D010361:Patients / Q000145:classification* / Q000706:statistics & numerical data*; D015203:Reproducibility of Results; D016896:Treatment Outcome