In earlier research, the study's lead author had found that women
with few social ties before a breast cancer diagnosis were at an
increased risk of death from the malignancy.
"I wanted to do this study in a large cohort of women to try and
replicate the findings I generated a decade ago," said Candyce
Kroenke, of Kaiser Permanent Northern California Division of
Research in Oakland.
For the new study, published December 12th in Cancer, the
researchers analyzed data collected from 9,267 women in the United
States and China within two years of their breast cancer diagnosis.
In addition to other information about the women, the researchers
had data on their relationships with spouses and friends and their
ties to religion, society and community.
Altogether, over about 11 years, there were 1,448 recurrences of
breast cancer and 1,521 deaths, including 990 deaths due to breast
Women with few social connections had a 43 percent higher risk of
breast cancer returning, compared to well-connected women, the
Similarly, isolated women were 64 percent more likely to die from
breast cancer and 69 percent more likely to die of any cause during
the course of the study, compared to their counterparts with many
The links between social isolation and poor outcomes were strongest
among women without advanced cancers.
Kroenke said the types of relationships that appeared to be
important to women's health varied.
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For example, not having a spouse or partner and having few community
ties was associated with an increased risk of death from breast
cancer among older white women, but not other women.
The study can't say why large social networks may help protect
women's health. Kroenke said it could be related to a number of
factors, including lifestyle, social support and physiology.
"It’s something we’re hoping to explore in the future," she said.
Doctors are increasingly recognizing social determinants of health
are important, said Kroenke. They should be aware of women's social
ties and support, and whether there is something clinically that can
be done to support patients.
"Women who are going through breast cancer should get the support
they need and ask for help," she said.
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