Study Finds People Who Have Breast Cancer Live Longer With Strong Social Support

Women with breast cancer tend to have better outcomes when they have a bigger network of friends, family and other social connections, but different types of social support were important for different women according to an article in the journal Cancer, from the American Cancer Society.

Background

Earlier studies have found that people who have larger networks of social relationships live longer, whether they are healthy or have breast cancer.  Over a given period of time, the studies saw more people with small social groups die than people with large social groups, such as family, friends or colleagues. While these studies found that the size of a person’s social group predicted if people were more likely to die of any cause, they did not show whether social group size impacts disease factors like recurrence, new breast cancers, or death from breast cancer.

Healthcare providers can use information about a person’s risks, whether the cause is medical, practical or social, to connect them to helpful resources.

Design

The After Breast Cancer Pooling Project used information from four existing cohorts, groups of people who are observed for a study, to look at the effects of social network size on breast cancer outcomes in 9,267 women with invasive breast cancer. A point system was used to measure the size of each woman’s social network. Women were assigned points for being in a romantic relationship, participating in volunteer work or a religious organization, and for how many friends and relatives they reported. The more points a person had, the more they were considered socially integrated, or having a strong network of social connections. A person with fewer points was considered more isolated.

Researchers were interested to see if social network size was connected to rates of death because of breast cancer, death by any cause, a new breast cancer diagnosis, and recurrence, the return of breast cancer. Other information collected about the participants included race and ethnicity, if they were in menopause, their education level, and lifestyle factors like smoking and exercise habits.

Results

Of the 9,267 women studied:

• 1,448 had a recurrence or were diagnosed with a new breast cancer
• 1,521 died of any cause
• 990 died as a result of breast cancer

The study found that women who were socially isolated, women with smaller groups of friends and family and involved in fewer social activities, were more at risk for a new breast cancer diagnosis or a breast cancer recurrence. They were more likely to die of breast cancer and more likely to die of any cause.

The women who had less social support also had less healthy lifestyles. They were less likely to exercise enough and more likely to smoke, be obese and drink more alcohol than recommended. Researchers say this was partly why the group had worse survival, but that it does not fully explain why their outcomes differed from women with large social networks.

Though this seemed to suggest that women with smaller social networks didn’t do as well as women with larger networks, the results were less clear when factors such as age, race and type of social ties were considered. Being single, for example, was tied to a higher chance of death by breast cancer and by any cause, but only in older white women. Having smaller groups of friends and family predicted worse outcomes in women of color but not white women, while stronger community and organizational ties only showed a benefit in Asian women and older white women. Whether a woman was active in a religious community showed no effect on outcomes.

These findings suggest that how a person’s social life affects their health outcomes depends on more than just the size of their social group. Their culture, personal characteristics and diagnosis also play a part, according to the researchers. And any simple measure of the size of a person’s social circle is probably not helpful in predicting if a person has a higher risk of recurrence or death.

What This Means for You

The most important factor in the behavior of cancer is the disease itself. This study adds to research that social support can affect your health and successful treatment, but it also shows that people find support in different ways. You may rely on a spouse or romantic partner as your primary caregiver, but that caregiver role may also be filled by a family member or a close friend. You may know many people through volunteer organizations or social groups, or you may lean on a close network of friends and family.

You may find it helpful to make new connections, but don’t feel you must change habits you are comfortable with. It’s important to get the support you need, emotionally and practically, whether it comes from many people or just a few or in your own company.

If you would like to find more support, there are many opportunities to connect with other people. Living Beyond Breast Cancer offers programs, groups and volunteer opportunities for people like you. You also may find social clubs and volunteer groups in your neighborhood. And you can call our Breast Cancer Helpline at (888) 753-LBBC (5222) to speak with someone who has been diagnosed with breast cancer and can help you find resources and support.

Kroenke, C; Michael, Y; Poole, E; et al.  Postdiagnosis social networks and breast cancer mortality in the After Breast Cancer Pooling Project. Cancer 123, Published online before print December 12, 2016. doi:10.1002/cncr.30440