PATTERNS OF CHANGE IN EMOTIONAL AND FUNCTIONAL WELL-BEING FOLLOWING BREAST CANCER DIAGNOSIS

Abstract Background: Understanding emotional and functional well-being (EWB and FWB) change in breast cancer (BC) survivors can facilitate targeted support for unmet needs. Methods: Among 2,767 women with BC in the Carolina Breast Cancer Study Phase 3, we assessed EWB and FWB with the Functional Assessment of Cancer Therapy – Breast (FACT-B) instrument at 5 (baseline), 25, and 84 months post-diagnosis. We identified well-being trajectories using latent class growth analysis, and relative frequency differences (RFDs) with 95% confidence intervals (CIs) were estimated for associations between trajectory group membership and demographic or clinical characteristics. Results: Five trajectory groups were identified for both EWB and FWB. Most participants (~70%) were classified into “good well-being” (“stable high” or “stable medium”). A small percentage (~10%) fell into “very low baseline” or “early decrease”, and the rest were “stable low” (~20%). Overall, younger vs. older age was associated with “stable low” EWB (25.4% vs. 19.3%; relative frequency difference [RFD] 6.1% [95% CI: 3.0%-9.2%]). Black participants more frequently had “stable low” FWB (24.2% vs. 16.6%; RFD 7.6% [95% CI: 4.6%-10.6%]). BC recurrence was strongly associated with “stable low” EWB (28.7% vs. 21.3%; RFD 7.3% [95% CI: 2.3%-12.3%]) and FWB (28.7% vs. 19.2%; RFD 8.6% [95% CI: 3.7%-13.5%]). Being unmarried, lower income, having non-private insurance, advanced stage, mastectomy vs. breast conservation surgery, and chemotherapy were also predictors of poor well-being trajectories. Conclusions: Demographics and clinical features are associated with sustained poor well-being after BC. Impact: Improvements in long-term well-being may warrant targeted support.