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Risk-reduction opportunities in breast cancer survivors: capitalizing on teachable moments

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Abstract

Purpose

With advancements in detection and treatment, the number of breast cancer survivors is growing. To reduce mortality among survivors, tailored health-promotion programs are needed to combat comorbidities. However, the demand for such programs exceed that which is available for a vastly diverse population of survivors. The goal of the present study was to describe the prevalence of comorbidities in a group of breast cancer survivors and to examine associations between biological proximal factors of and the more distal individual-level factors on the number and types of comorbidities.

Methods

In addition to medical chart reviews, breast cancer survivors (N = 369) from hospitals in two urban locations completed self-report measures. Bivariate analyses examined the relationship between distal and proximal predictors and the outcomes: number of comorbidities and comorbidity types.

Results

Both proximal and distal factors were associated with comorbidities. African American, women with lower education attainment, and older women were more likely to be obese and have more comorbidities than their counterparts. In particular, they were more at risk for cardiovascular disease. Those who initiated hormonal therapy, chemotherapy, and radiation therapy were more likely to have comorbidities. Several psychosocial variables were related to proximal psychosocial factors.

Conclusions

The present findings highlight the need for targeted health-promotion treatments for breast cancer survivors, particularly for African Americans, those with lower education attainment, those who are obese, and those who may be older. Given the relationships between specific comorbidities and proximal psychosocial factors, future interventions may benefit from tailored approaches.

Implications for cancer survivors

Tailored interventions for survivors may be more effective when accounting for factors associated with health-promotion engagement.

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Acknowledgments

This work was funded in part by grants from the American Cancer Society (Sheppard: PI MRSGT-06-132 CPPB), Komen for the Cure, Inc. (PI: Sheppard POP0503398), and the National Cancer Institute (Mandelblatt: RO1 CA124924, RO1 CA 127617, and KO5 CA96940).

Informed consent

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000 (5). Informed consent was obtained from all patients for being included in the study.

Conflicts of interest

The authors have no conflicts of interest to declare.

Author information

Authors and Affiliations

  1. Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA

    Krista Beth Highland

  2. Breast Cancer Program, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, 3800 Reservoir Rd, Washington, DC, 20057, USA

    Alejandra Hurtado-de-Mendoza & Vanessa B. Sheppard

  3. Cancer Prevention and Control Program, Georgetown University Medical Center, 3300 Whitehaven Street NW, Suite 4100, Washington, DC, 20007, USA

    Cassandra A. Stanton & Chiranjeev Dash

  4. Office of Minority Health and Health Disparities Research, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, 1000 New Jersey Ave. SE, Washington, DC, 20003, USA

    Chiranjeev Dash & Vanessa B. Sheppard

Authors
  1. Krista Beth Highland
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  2. Alejandra Hurtado-de-Mendoza
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  3. Cassandra A. Stanton
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  4. Chiranjeev Dash
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  5. Vanessa B. Sheppard
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Corresponding author

Correspondence to Krista Beth Highland.

Additional information

Dr. Highland completed the present manuscript while at the Cancer Prevention Control Program at Georgetown University Medical Center.

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Highland, K.B., Hurtado-de-Mendoza, A., Stanton, C.A. et al. Risk-reduction opportunities in breast cancer survivors: capitalizing on teachable moments. Support Care Cancer 23, 933–941 (2015). https://doi.org/10.1007/s00520-014-2441-7

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  • DOI: https://doi.org/10.1007/s00520-014-2441-7

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