title: Examining health-related quality of life patterns in women with breast cancer.
abstract: We aimed to identify subgroups of women with breast cancer who experience different health-related quality of life (HRQOL) patterns during active treatment and survivorship and determine characteristics associated with subgroup membership.
  
  
  
  We used data from the third phase of the population-based Carolina Breast Cancer Study and included 2142 women diagnosed with breast cancer from 2008 to 2013. HRQOL was measured, on average, 5 and 25 months post diagnosis. Latent profile analysis was used to identify HRQOL latent profiles (LPs) at each time point. Latent transition analysis was used to determine probabilities of women transitioning profiles from 5 to 25 months. Multinomial logit models estimated adjusted odds ratios (aORs) and 95% confidence intervals for associations between patient characteristics and LP membership at each time point.
  
  
  
  We identified four HRQOL LPs at 5 and 25 months. LP1 had the poorest HRQOL and LP4 the best. Membership in the poorest profile at 5 months was associated with younger age aOR 0.95; 0.93-0.96, White race aOR 1.48; 1.25-1.65, being unmarried aOR 1.50; 1.28-1.65 and having public aOR 3.09; 1.96-4.83 or no insurance aOR 6.51; 2.12-20.10. At 25 months, Black race aOR 1.75; 1.18-1.82 was associated with the poorest profile membership. Black race and smoking were predictors of deteriorating to a worse profile from 5 to 25 months.
  
  
  
  Our results suggest patient-level characteristics including age at diagnosis and race may identify women at risk for experiencing poor HRQOL patterns. If women are identified and offered targeted HRQOL support, we may see improvements in long-term HRQOL and better breast cancer outcomes.
authors.affiliation: Department of Health Policy and Management, University of North Carolina, Chapel Hill, USA. lpinheir@live.unc.edu.
authors.forename: Laura C
authors.initials: LC
authors.lastname: Pinheiro
authors.affiliation: Department of Biostatistics, Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, USA.
authors.forename: Xianming
authors.initials: X
authors.lastname: Tan
authors.affiliation: Department of Epidemiology, Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, USA.
authors.forename: Andrew F
authors.initials: AF
authors.lastname: Olshan
authors.affiliation: Department of Health Policy and Management, Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, USA.
authors.forename: Stephanie B
authors.initials: SB
authors.lastname: Wheeler
authors.affiliation: University of North Carolina Breast Cancer, Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, USA.
authors.forename: Katherine E
authors.initials: KE
authors.lastname: Reeder-Hayes
authors.affiliation: Department of Health Policy and Management, Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, USA.
authors.forename: Cleo A
authors.initials: CA
authors.lastname: Samuel
authors.affiliation: Department of Health Policy and Management, Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, USA.
authors.forename: Bryce B
authors.initials: BB
authors.lastname: Reeve
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000523:psychology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D011788:Quality of Life / Q000523:psychology*
keywords: Breast cancer; Health-related quality of life; Latent profiles