{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T14:36:57Z","timestamp":1788964617325,"version":"build-2803163510"},"reference-count":45,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2024,11,9]],"date-time":"2024-11-09T00:00:00Z","timestamp":1731110400000},"content-version":"vor","delay-in-days":8,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Psycho-Oncology"],"published-print":{"date-parts":[[2024,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Social support, social strain and stressful life events could induce chronic stress, which affects prognosis and survival after breast cancer diagnosis. However, few studies have examined the impact of psychosocial factors on different competing mortality events.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We included 9154 postmenopausal women who were newly diagnosed with invasive breast cancer after enrollment in the Women's Health Initiative, as of March 6th, 2021. Psychosocial factors were collected and stratified into quartiles. Cause of death was verified through adjudicated medical record reviews. Associations between psychosocial factors and all\u2010cause mortality, breast cancer mortality, and cardiovascular disease mortality were examined by competing risk models. Subsequent stratified analyses were performed by race.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>With a median follow\u2010up time of 8.6\u00a0years, 3218 deaths were identified. Compared to participants with less social support, those who had higher social support had significantly lower all\u2010cause mortality (Q4 vs. Q1, HR\u00a0=\u00a00.89, 95% CI: 0.81, 0.9). The highest quartile of social strain was associated with lower CVD mortality (Q4 vs. Q1: HR\u00a0=\u00a00.80, 95% CI: 0.65, 0.99). After stratification, a similar relationship was found in White women but not in Black women.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our findings suggest that there was an association between high social support and reduced all\u2010cause mortality regardless of cancer stages at diagnosis. Social support interventions after breast cancer diagnosis could have the potential to reduce overall mortality.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pon.70013","type":"journal-article","created":{"date-parts":[[2024,11,9]],"date-time":"2024-11-09T11:19:02Z","timestamp":1731151142000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Social Support, Social Strain, Stressful Life Events and Mortality Among Postmenopausal Women With Breast Cancer"],"prefix":"10.1002","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9568-9418","authenticated-orcid":false,"given":"Fengge","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Epidemiology and Biostatistics School of Public Health Indiana University  Bloomington Indiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael S.","family":"Simon","sequence":"additional","affiliation":[{"name":"Department of Oncology Karmanos Cancer Institute at Wayne State University  Detroit Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6128-3118","authenticated-orcid":false,"given":"Candyce H.","family":"Kroenke","sequence":"additional","affiliation":[{"name":"Division of Research Kaiser Permanente Northern California  Oakland California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica","family":"Krok\u2010Schoen","sequence":"additional","affiliation":[{"name":"School of Health and Rehabilitation Sciences The Ohio State University  Columbus Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Su Yon","family":"Jung","sequence":"additional","affiliation":[{"name":"Translational Sciences Section School of Nursing Jonsson Comprehensive Cancer Center University of California  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rowan","family":"Chlebowski","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology The Lundquist Institute  Torrance California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tarah J.","family":"Ballinger","sequence":"additional","affiliation":[{"name":"Department of Medicine Indiana University School of Medicine  Indianapolis Indiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margaret S.","family":"Pichardo","sequence":"additional","affiliation":[{"name":"Howard University College of Medicine  Washington DC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mace","family":"Coday","sequence":"additional","affiliation":[{"name":"Department of Preventive Medicine University of Tennessee Health Science Center  Memphis Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorena","family":"Garcia","sequence":"additional","affiliation":[{"name":"Department of Public Health Sciences University of California Davis School of Medicine  Davis California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juhua","family":"Luo","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics School of Public Health Indiana University  Bloomington Indiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,11,9]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21754"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2021203476"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neubiorev.2009.09.003"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10549\u2010019\u201005340\u20107"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.critrevonc.2009.06.003"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10549\u2010012\u20101962\u20103"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.31943"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.2105\/ajph.2018.304864"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/obr.12915"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djaa096"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10549\u2010012\u20102253\u20108"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamacardio.2016.3841"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/ecc.13231"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1158\/1055\u20109965.epi\u201017\u20100569"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.163.1.49"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10552\u2010021\u201001392\u20107"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1161\/circulationaha.118.033915"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ssmph.2018.11.003"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/s1047\u20102797(03)00043\u20107"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0197-2456(97)00078-0"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/s1047\u20102797(03)00048\u20106"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1136\/jech.2008.084814"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/0277\u20109536(91)90150\u2010b"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.2307\/585268"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1161\/jaha.113.000687"},{"key":"e_1_2_10_27_1","unstructured":"The CES\u2010D Scale: A Self\u2010Report Depression Scale for Research in the General Population \u2010 Lenore Sawyer Radloff(1977) https:\/\/journals.sagepub.com\/doi\/abs\/10.1177\/014662167700100306?casa_token=j7Pj7NG2ETwAAAAA%3AxWaztgQL5IGF2C\u20108EGnjzdqnEjoumMnevC5CatiZWabJBYZhoutsmjl03NSdjzRyJmk6URD5nyA&"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10552\u2010022\u201001630\u20106"},{"key":"e_1_2_10_29_1","unstructured":"G.Anderson Women\u2019s Health Initiative 2021 Annual Progress Report. [Internet] (2021) https:\/\/www.whi.org\/doc\/2021\u2010Annual.pdf."},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.1017\/CBO9780511790874"},{"key":"e_1_2_10_31_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bjc.6601120"},{"key":"e_1_2_10_32_1","doi-asserted-by":"publisher","DOI":"10.1093\/biostatistics\/kxr032"},{"key":"e_1_2_10_33_1","doi-asserted-by":"publisher","DOI":"10.1111\/insr.12214"},{"key":"e_1_2_10_34_1","doi-asserted-by":"publisher","DOI":"10.1080\/01621459.1999.10474144"},{"key":"e_1_2_10_35_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen\u20102016\u2010011503"},{"key":"e_1_2_10_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychores.2008.12.012"},{"key":"e_1_2_10_37_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.psy.48.3.211"},{"key":"e_1_2_10_38_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bjc.6603091"},{"key":"e_1_2_10_39_1","doi-asserted-by":"publisher","DOI":"10.1200\/jco.2005.04.2846"},{"key":"e_1_2_10_40_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.30440"},{"key":"e_1_2_10_41_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0173370"},{"key":"e_1_2_10_42_1","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.1511085112"},{"key":"e_1_2_10_43_1","doi-asserted-by":"publisher","DOI":"10.1177\/0145721706291760"},{"key":"e_1_2_10_44_1","doi-asserted-by":"publisher","DOI":"10.1177\/0095798412469227"},{"key":"e_1_2_10_45_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.socnet.2013.08.004"},{"key":"e_1_2_10_46_1","volume-title":"Find Breast Cancer Support Groups in Your Area & Online"}],"container-title":["Psycho-Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pon.70013","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,23]],"date-time":"2025-08-23T15:26:27Z","timestamp":1755962787000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/pon.70013"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,11]]},"references-count":45,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2024,11]]}},"alternative-id":["10.1002\/pon.70013"],"URL":"https:\/\/doi.org\/10.1002\/pon.70013","archive":["Portico"],"relation":{},"ISSN":["1057-9249","1099-1611"],"issn-type":[{"value":"1057-9249","type":"print"},{"value":"1099-1611","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,11]]},"assertion":[{"value":"2024-02-02","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-10-16","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-11-09","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70013"}}