Background Younger survivors (YS) of breast cancer often report more survivorship symptoms such as fatigue, depression, sexual difficulty, and cognitive problems than older survivors (OS). We sought to determine the effect of breast cancer and age at diagnosis on Quality of Life (QoL) by comparing 3 groups: 1) YS diagnosed at age 45 or before, 2) OS diagnosed between 55 and 70, and, 3) for the YS, age-matched controls (AC) of women not diagnosed with breast cancer. Methods Using a large Eastern Cooperative Oncology Group (ECOG) data base, we recruited 505 YS who were ages 45 or younger when diagnosed and 622 OS diagnosed at 55 to 70. YS, OS, and AC were compared on physical, psychological, social, spiritual, and overall QoL variables. Results Compared to both AC and to OS, YS reported more depressive symptoms (p=.005) and fatigue (p<.001), poorer self-reported attention function (p<.001), and poorer sexual function (p<.001) than either comparison group. However, YS also reported a greater sense of personal growth (p<.001) and perceived less social constraint (p<.001) from their partner than AC. Conclusions YS reported worse functioning than AC relative to depression, fatigue, attention, sexual function, and spirituality. Perhaps even more important, YS fared worse than both AC and OS on body image, anxiety, sleep, marital satisfaction, and fear of recurrence, indicating that YS are at greater risk for long term QoL problems than survivors diagnosed at a later age.

Purpose/Objectives To determine the effect that age at diagnosis has on fear of breast cancer recurrence and to identify the predictors of fear of recurrence using self-efficacy as a mediator. Design Cross-sectional survey. Setting Two university cancer centers and one cooperative group in the midwestern United States. Sample 1,128 long-term survivors. Methods Survivors were eligible if they were aged 18–45 years (younger group) or 55–70 years (older group) at cancer diagnosis, had received chemotherapy, and were three to eight years postdiagnosis. Fear of recurrence was compared between younger and older groups. Multiple regression analyses were used to test variables’ prediction of fear of recurrence and breast cancer survivor self-efficacy, as well as breast cancer survivor self-efficacy mediation effects. Main Research Variables Fear of recurrence, breast cancer survivor self-efficacy, and age at diagnosis. Findings Survivors diagnosed at a younger age had significantly higher fear of recurrence, as well as health, role, womanhood, death, and parenting worries. Perceived risk of recurrence, trait anxiety, and breast cancer reminders explained significant variance in fear of recurrence and breast cancer survivor self-efficacy. Breast cancer survivor self-efficacy partially mediated the effects of variables on fear of recurrence. Conclusions The findings suggest that breast cancer survivor self-efficacy may have a protective effect for survivors who are younger at diagnosis and have higher perceived risk of recurrence, higher trait anxiety, and more breast cancer reminders. Oncology nurses already use the skills required to support self-efficacy. Additional research is needed to define and test breast cancer survivor self-efficacy interventions. Implications for Nursing Oncology nurses are in a key role to assess fear of recurrence and provide self-efficacy interventions to reduce it in breast cancer survivors. Strategies to efficiently address fear of recurrence to reduce psychological distress in survivorship follow-up care are warranted.

Background The diagnosis and treatment of breast cancer can result in an array of late cancer-specific side effects and changes in general well-being. Research has focused on Caucasian samples, limiting our understanding of the unique health-related quality of life outcomes of African American breast cancer survivors (BCS). Even when African American BCS have been targeted, research is limited by small samples and failure to include comparisons of peers without a history of breast cancer. Objective The purpose of this study was to compare health-related quality of life of African American women BCS to African American women with no history of breast cancer (control group). Methods A total of 140 women (62 BCS and 78 control), ages 18 years or older and 2–10 years post-diagnosis, was recruited from a breast cancer clinic and cancer support groups. Participants provided informed consent and completed a one-time survey based on Brenner’s (1995) proximal-distal health-related quality of life model. Results After adjusting for age, education, income, and body mass index, African American BCS experienced more fatigue (p=0.001), worse hot flashes (p<0.001) and worse sleep quality (p<0.001), but more social support from their partner (p=0.028) and more positive change (p=0.001) compared to African American women controls. Conclusions Our results suggest that African American women BCS may experience unique health-related outcomes that transcend age, education, socio-economic status and body mass index. Implications for Practice Findings suggest the importance of understanding the survivorship experience for particular racial and ethnic subgroups to proactively assess difficulties and plan interventions.