Post-traumatic growth among elderly women with breast cancer compared to breast cancer-free women

Figures & data

Figure 1. The light-grey boxes show the study population used in the analyses of PTG according to BC status. The dark-grey box shows the study population used in the analyses of BC characteristics and treatment and PTG.

Table I. Descriptive characteristics of women with breast cancer (BC) and BC-free women in the Diet, Cancer and Health cohort, Denmark.

	Women with BC n = 774	BC-free women n = 666
Age at second follow-up (years)	Mean: 70, range: 63–80	Mean: 70, range: 64–81
Education (years) ≤ 7 8–10 > 10	203 (26%) 407 (52%) 164 (21%)	159 (24%) 347 (52%) 160 (24%)
Mean Overall PTG ± SD	36.0 ± 26	34.2 ± 26
Mean PTG domains ± SD Appreciation of life New possibilities Personal strength Spiritual change Relating to others	7.0 ± 4.8 7.0 ± 6.8 7.5 ± 5.9 1.7 ± 2.5 12.7 ± 9.7	6.2 ± 4.7 7.4 ± 6.9 7.2 ± 6.0 1.6 ± 2.6 11.7 ± 9.8
Time since operation (years)	n = 684 Mean: 6.9, range: 0.5–15.5
Tumor size (mm) 0–9 10–19 20–29 30–39 40–49 ≥ 50	123 (18%) 322 (47%) 159 (23%) 47 (7%) 20 (3%) 13 (2%)
Number of positive lymph nodes 0 1–3 ≥ 4	406 (59%) 199 (29%) 79 (12%)
Grade of malignancy 0 (carcinoma in situ) I II III Not registered Missing	3 (0.5%) 228 (38%) 259 (43%) 97 (16%) 11 (2%) 86
Histology Ductal Lobular Other Unclassified	549 (80%) 82 (11%) 46 (7%) 7 (1%)
Radiation therapy Received treatment Did not receive treatment	501 (73%) 183 (27%)
Chemotherapy Received treatment Did not receive treatment	95 (14%) 589 (86%)
Endocrine treatment Received treatment Did not receive treatment	369 (54%) 315 (46%)
Type of surgery Mastectomy Lumpectomy Lumpectomy followed by mastectomy	307 (45%) 368 (54%) 9 (1%)

Figure 2. Choice of traumatic experience reported by the women with BC (n = 774) and BC-free women (n = 666) in the Diet, Cancer and Health cohort, Denmark. The categories on the x axis correspond to the categories of traumatic experience available in the questionnaire.

Table II. Regression-derived coefficients (β) and 95% confidence intervals (CIs) of overall and domain-specific post-traumatic growth (PTG) by breast cancer (BC) diagnosis status among 1440 women in the Diet, Cancer and Health cohort study.

	Unadjusted		Adjusted^2
	β	95% CI	β	95% CI
BC^1 Overall PTG Appreciation of life New possibilities Personal strength Spiritual change Relating to others	1.83 0.81* −0.39 0.26 0.11 1.03*	−0.88; 4.54 0.31; 1.30 −1.09; 0.32 −0.36; 0.88 −0.16; 0.38 0.02; 2.04	^4 1.86 0.80* −0.36 0.27 0.12 1.03*	−0.85; 4.57 0.31; 1.29 −1.06; 0.34 −0.35; 0.88 −0.15; 0.38 0.03; 2.04
Age (years)^2 Overall PTG	−0.51*	−0.82; −0.19	−0.50*^5	−0.82; −0.18
Education3 Overall PTG	−3.05	−6.98; 0.87	−2.53^6	−6.46; 1.40

*, statistically significant; ¹Reference group, BC-free women; ²β-value applies to increasing age; ³Education stratified according to number of years: ≤ 7, 8–10, > 10. β-value applies to a higher level of education; ⁴Adjusted for education and age at second follow-up; ⁵Adjusted for education; ⁶Adjusted for age at second follow-up.

Table III. Regression-derived coefficients (β) and 95% confidence intervals (CIs) for overall and domain-specific post-traumatic growth (PTG) by age, education, characteristics and treatment of disease, N = 684 women with breast cancer.

	Unadjusted		Adjusted
	β	95% CI	β	95% CI
Time since^1 operation (months) Overall PTG	0.04*	0.001; 0.08	0.04*^6	0.002; 0.08
Tumor size (mm)^2 Overall PTG Appreciation of life New possibilities Personal strength Spiritual change Relating to others	0.19* 0.04* 0.03 0.04* 0.001 0.08*	0.02; 0.36 0.007; 0.07 −0.02; 0.07 0.001; 0.08 −0.01; 0.02 0.02; 0.15	^7 0.22* 0.05* 0.04 0.05* 0.003 0.09*	0.05; 0.40 0.01; 0.08 −0.008; 0.08 0.006; 0.09 −0.01; 0.02 0.03; 0.16
Number of positive lymph nodes^3 Overall PTG Appreciation of life New possibilities Personal strength Spiritual change Relating to others	0.53 0.08 0.08 0.10 0.07* 0.20	−0.05; 1.11 −0.03; 0.19 −0.07; 0.23 −0.03; 0.24 0.01; 0.13 −0.02; 0.42	^7 0.60* 0.10 0.10 0.11 0. 08* 0.22*	0.02; 1.18 −0.01; 0.20 −0.05; 0.25 −0.02; 0.25 0.02; 0.13 0.0006; 0.43
Type of surgery^4 Overall PTG Appreciation of life New possibilities Personal strength Spiritual change Relating to others	4.77* 0.58 0.98 1.27* 0.13 1.81*	0.82; 8.71 −0.15; 1.31 −0.05; 2.00 0.37; 2.18 −0.25; 0.51 0.34; 3.28	^7 4.59* 0.60 0.78 1.33* 0.08 1.78*	0.54; 8.64 −0.14; 1.35 −0.28; 1.83 0.41; 2.26 −0.31; 0.48 0.27; 3.30*
Radiation therapy^5 Overall PTG Appreciation of life New possibilities Personal strength Spiritual change Relating to others	0.95 0.34 0.04 0.04 0.20 0.32	−3.47; 5.37 −0.48; 1.16 −1.10; 1.19 −0.97; 1.06 −0.22; 0.62 −1.33; 1.97	^7 0.58 0.16 0.13 −0.12 0.20 0.22	−3.93; 5.10 −0.67; 0.99 −1.05; 1.31 −1.16; 0.92 −0.23; 0.63 −1.47; 1.91
Chemotherapy^5 Overall PTG Appreciation of life New possibilities Personal strength Spiritual change Relating to others	2.76 0.77 0.42 0.86 −0.18 0.89	−2.90; 8.41 −0.27; 1.81 −1.05; 1.89 −0.44; 2.15 −0.72; 0.36 −1.22; 3.00	^7 2.36 0.65 0.44 0.73 −0.19 0.71	−3.29; 8.00 −0.38; 1.69 −1.03; 1.91 −0.56; 2.03 −0.73; 0.36 −0.40; 2.83
Endocrine treatment^5 Overall PTG Appreciation of life New possibilities Personal strength Spiritual change Relating to others	2.22 0.57 0.38 0.23 0.11 0.93	−1.70; 6.15 −0.15; 1.30 −0.64; 1.40 −0.67; 1.13 −0.26; 0.49 −0.53; 2.39	^7 3.80 0.83* 0.85 0.44 0.22 1.43	−0.29; 7.83 0.09; 1.58 −0.21; 1.90 −0.49; 1.38 −0.17; 0.61 −0.09; 2.95

*, statistically significant; ¹β-value applies to increasing time since operation; ²β-value applies to increasing tumor size; ³β-value applies to increasing number of positive lymph nodes (lymph nodes with metastases); ⁴Reference group, women who underwent lumpectomy; ⁵Reference group, women with BC who received no treatment (radiation, chemo- or endocrine treatment); ⁶Adjusted for age at second follow-up and education; ⁷Adjusted for age at second follow-up, education and time since operation.