title: Distress and quality of life in an ethnically diverse sample awaiting breast cancer surgery.
abstract: Poor breast cancer-related quality of life is associated with flattened cortisol rhythms and inflammation in breast cancer survivors and women with advanced disease. We explored the associations of cancer-specific distress (Impact of Events Scale), mood (Profile of Mood States), activity/sleep (wake after sleep onset, 24-hour autocorrelation coefficient) and cortisol (diurnal slope) circadian rhythms, and inflammation (interleukin-6) with quality of life (Functional Assessment of Cancer Therapy-Breast) among patients awaiting breast cancer surgery ( N = 57). Models were adjusted for differences in age and cancer stage. Distress and mood disturbance were significantly correlated with lower quality of life. Ethnic differences in the relationship between distress and mood disturbance with global quality of life and subscales of quality of life were observed. Actigraphic measures showed that in comparison with non-Hispanic patients, African Americans had significantly poorer activity/sleep (wake after sleep onset, 24-hour autocorrelation coefficient). Circadian disruption and inflammation were not associated with quality of life. Physiological dysregulation and associated comorbidities may take time to develop over the course of disease and treatment.
authors.affiliation: 1 University of Louisville, USA.
authors.forename: Whitney N
authors.initials: WN
authors.lastname: Rebholz
authors.affiliation: 1 University of Louisville, USA.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Cash
authors.affiliation: 1 University of Louisville, USA.
authors.forename: Lauren A
authors.initials: LA
authors.lastname: Zimmaro
authors.affiliation: 1 University of Louisville, USA.
authors.forename: René
authors.initials: R
authors.lastname: Bayley-Veloso
authors.affiliation: 1 University of Louisville, USA.
authors.forename: Kala
authors.initials: K
authors.lastname: Phillips
authors.affiliation: 1 University of Louisville, USA.
authors.forename: Chelsea
authors.initials: C
authors.lastname: Siwik
authors.affiliation: 2 Yale University, USA.
authors.forename: Anees B
authors.initials: AB
authors.lastname: Chagpar
authors.affiliation: 3 Stanford University, USA.
authors.forename: Firdaus S
authors.initials: FS
authors.lastname: Dhabhar
authors.affiliation: 3 Stanford University, USA.
authors.forename: David
authors.initials: D
authors.lastname: Spiegel
authors.affiliation: 1 University of Louisville, USA.
authors.forename: Brittany Saltsman
authors.initials: BS
authors.lastname: Bell
authors.affiliation: 1 University of Louisville, USA.
authors.forename: Sandra E
authors.initials: SE
authors.lastname: Sephton
mesh_terms: D056044:Actigraphy; D000328:Adult; D000339:Affect / Q000502:physiology*; D000368:Aged; D001943:Breast Neoplasms / Q000208:ethnology* / Q000523:psychology* / Q000601:surgery; D002940:Circadian Rhythm / Q000502:physiology*; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000378:metabolism*; D008875:Middle Aged; D011788:Quality of Life
chemical_list: D006854:Hydrocortisone
keywords: breast cancer; ethnicity; mood disturbance; psychological distress; quality of life