Abstract A50: Comparison of social support, social integration, overall quality of life, and recurrence-free survival between white and African American breast cancer survivors

Introduction: While African American women have a lower incidence of breast cancer compared to their white counterparts, African American women display higher rates of breast cancer mortality. Despite the plethora of studies examining the role of social support, social integration, and quality of life (QOL) on breast cancer survival, very few studies have focused on the nature of these relationships among African American women. Methods: Descriptive statistics were used to assess the demographic, social support, social integration, and overall QOL characteristics of white and African American breast cancer survivors enrolled in theWomen9s Healthy Eating and Living (WHEL) Study. Additionally, comparisons were made using an independent samples t-test for continuous variables and a chi-square test for categorical variables. The method of Kaplan and Meier was also used to compare recurrence-free survival between white and African-American survivors. A cut-point of 80 was used to classify women as having low or high self-reported QOL. Five year Kaplan-Meier estimates of recurrence-free survival were used to compare white and African American participants with high and low self-reported QOL. Results: When examining the social support subscales, white women enrolled in the WHEL study reported significantly higher affection, while African American survivors reported higher social strain, and hostility. Overall, QOL was significantly higher for white participants compared to African American participants (p-value = 0.007). Assessment of the physical health components of QOL demonstrated that white participants reported an average score that was significantly higher compared to African American participants (p-value = .002). Additionally, assessment of the mental health components of QOL, suggested that white women reported higher average scores compared to African American participants (p-value = 0.091). The five-year recurrence-free survival estimates for white and African American breast cancer survivors were 89.0% and 81.2% respectively. The five-year recurrence-free survival estimates for white women with low and high QOL were 91.1% and 87.2%. Yet, the five-year recurrence-free survival estimates for African American women with low and high QOL were 73.9% and 88.2%. Therefore, white participants with low self-reported QOL had the most favorable five-year recurrence-free survival (91.1%) compared to African American participants with low self-reported QOL (73.9%). Conclusions: This study suggests that lower self-reported QOL may potentially mediate survival outcomes for African American women diagnosed with breast cancer.