Pre-diagnostic allostatic load and health-related quality of life in a cohort of Black breast cancer survivors

Cathleen Y. Xing, Michelle Doose, Bo Qin, Yong Lin, Tiffany L. Carson, Jesse J. Plascak, Kitaw Demissie, Chi Chen Hong, Elisa V. Bandera, Adana A.M. Llanos

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


Purpose: To determine the association of pre-diagnostic allostatic load (AL) with health-related quality of life (HRQOL) among Black women with breast cancer. Methods: In a sample of 409 Black women with non-metastatic breast cancer enrolled in the Women’s Circle of Health Follow-Up Study (WCHFS), two pre-diagnostic AL measures were estimated using medical records data from up to 12 months prior to breast cancer diagnosis: AL-lipid/metabolic profile-based measure and AL-inflammatory profile-based measure. HRQOL was assessed approximately 24 months post diagnosis, using the Functional Assessment of Cancer Therapy-Breast Cancer (FACT-B) instrument, including 5 subscale scores [presented by physical well-being (PWB), social & family well-being (SFWB), emotional well-being (EWB), functional well-being (FWB), and breast cancer-specific scale (BCS)] and 3 derived total scores [presented by trial outcome index (TOI), Functional Assessment of Cancer Therapy-General (FACT-G) and FACT-B]. We used multivariable logistic regression models, using dichotomized AL scores (lower AL: 0–3 points, higher AL: 4–8 points), to assess the associations between the two pre-diagnostic AL measures and HRQOL. Results: Higher pre-diagnostic AL was associated with poorer FWB and lower FACT-G, but these associations were statistically significant for the AL-inflammatory profile-based measure (FWB: OR 1.63, 95% CI 1.04, 2.56; FACT-G: OR 1.62, 95% CI 1.04, 2.54), but not the AL-lipid/metabolic profile-based measure (FWB: OR 1.45, 95% CI 0.81, 2.59; FACT-G: OR 1.33, 95% CI 0.75, 2.37). Conclusion: These findings suggest that higher AL, particularly when measured using the inflammatory profile-based measure, was associated with poorer HRQOL, namely FWB and FACT-G, among Black breast cancer survivors.

Original languageEnglish (US)
Pages (from-to)901-914
Number of pages14
JournalBreast Cancer Research and Treatment
Issue number3
StatePublished - Dec 2020

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research


  • Allostatic load
  • Black women
  • Breast cancer survivorship
  • Health-related quality of life
  • Longitudinal study


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