title: Quality of life of older African American breast cancer survivors: a population-based study.
abstract: Factors associated with lower health-related quality of life (HRQOL) among older African American (AA) breast cancer survivors (BCS) have not been elucidated.
  
  
  
  Using the Surveillance, Epidemiology, and End Results-Medicare Health Outcome Survey linked dataset, all resected AA BCS over 65 were identified. Using the most recent survey after diagnosis, individuals with a VR12 physical (PCS) or mental (MCS) component score 10 points lower than the median were categorized as having poor HRQOL. Univariate and multivariate (MV) analyses identified predictors of poor HRQOL.
  
  
  
  Of 373 AA BCS (median age 74.6), median time from diagnosis to survey was 68.4 months with median follow-up of 138.6 months. Median PCS was 35.9 (IQR 28.5-44.5) with 76 (20.1%) reporting poor PCS. Median MCS was 50.6 (IQR 41.3-59.1) with 101 (27.1%) reporting poor MCS. Predictors of poor PCS included advanced age, larger tumor size, ≥2 comorbidities, inability to perform >2 of 6 activities of daily living (ADLs), modified/radical mastectomy, infiltrating lobular carcinoma, and stage III or IV disease (all p < 0.05). Comorbidities ≥2 and inability to perform >2 of 6 ADLs (p < 0.05) predicted poor MCS. Inability to perform >2 of 6 ADLs was the only independent predictor of poor PCS (OR 10.9, 95% CI 3.0-39.3; p < 0.001) and MCS (OR 7.6, 95% CI 4.3-13.3; p < 0.001).
  
  
  
  In elderly AA BCS, poor HRQOL was not associated with socioeconomic status or tumor-specific factors but rather impairment in ADLs. Physical and mental HRQOL in African American breast cancer survivors is not dependent on socioeconomic or tumor-related characteristics, but rather on inability to perform ADLs.
authors.affiliation: Division of Surgical Oncology, Department of General Surgery, Wake Forest University Baptist Medical Center, Medical Center Blvd., Winston-Salem, NC, 27157, USA.
authors.forename: Harveshp D
authors.initials: HD
authors.lastname: Mogal
authors.affiliation: Division of Surgical Oncology, Department of General Surgery, Wake Forest University Baptist Medical Center, Medical Center Blvd., Winston-Salem, NC, 27157, USA.
authors.forename: Marissa
authors.initials: M
authors.lastname: Howard-McNatt
authors.affiliation: Division of Surgical Oncology, Department of General Surgery, Wake Forest University Baptist Medical Center, Medical Center Blvd., Winston-Salem, NC, 27157, USA.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Dodson
authors.affiliation: Department of Biostatistical Sciences, Wake Forest University Baptist Medical Center, Winston-Salem, NC, USA.
authors.forename: Nora F
authors.initials: NF
authors.lastname: Fino
authors.affiliation: Division of Surgical Oncology, Department of General Surgery, Wake Forest University Baptist Medical Center, Medical Center Blvd., Winston-Salem, NC, 27157, USA. cjclark@wakehealth.edu.
authors.forename: Clancy J
authors.initials: CJ
authors.lastname: Clark
mesh_terms: D000203:Activities of Daily Living; D001741:Black or African American; D000367:Age Factors; D000368:Aged; D001943:Breast Neoplasms / Q000208:ethnology / Q000473:pathology / Q000503:physiopathology* / Q000523:psychology*; D015331:Cohort Studies; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D011788:Quality of Life; D012189:Retrospective Studies; D017741:Survivors
keywords: African American; Breast cancer survivor; HRQOL; MCS; PCS