What is the clinical evidence from this study?

Study design: Cohort. Population: Breast cancer (n=739). Intervention: Social support (emotional support, social/family well-being, social network size) vs. Lower social support. Primary outcome: Probability of being a rapid decliner in deficit accumulation (per 10-point increase in emotional social support) (aOR 0.77, 95% CI 0.65-0.92).

What question did this study set out to answer?

This research aims to characterize deficit accumulation trajectories in older breast cancer survivors and non-cancer controls while evaluating the role of social support.

April 5, 2026

Abstract 2465: Social support as a predictor of deficit accumulation in older breast cancer survivors and non-cancer controls

Key Result

Higher emotional social support significantly reduced the probability of rapid deficit accumulation in older breast cancer survivors and controls (aOR 0.77; 95% CI 0.65-0.92 per 10-point increase).

Key Points

This research aims to characterize deficit accumulation trajectories in older breast cancer survivors and non-cancer controls while evaluating the role of social support.
Included 380 breast cancer survivors and 359 controls from 2010-2022 with annual follow-ups through 2024.
Assessed deficit accumulation using a 46-item index at each visit.
Utilized trajectory modeling to identify distinct patterns of deficit accumulation and multinomial logistic regression to establish predictors.
Identified three trajectories: rapid decliners (28%), slow decliners (49%), and non-decliners (23%).
Breast cancer survivors showed a higher likelihood of rapid decline compared to controls.
Higher emotional support linked to lower odds of being a slow or rapid decliner, with a 10-point increase reducing progression risk by 14-23%.
More than three close friends correlated with a 65% lower probability of rapid decline.

Study Design

Type

Cohort (n=739)

Structured PICO

Does higher social support prevent rapid deficit accumulation in older breast cancer survivors and non-cancer controls?

Population

380 older breast cancer survivors and 359 frequency-matched non-cancer controls

Intervention

Higher social health measures (emotional and tangible support via MOS-SS, social and family well-being via FACT-G, and social network size >3 close friends/relatives)

Comparator

Lower social support / non-cancer controls

Outcome

Long-term deficit accumulation trajectories assessed using a 46-item indexpatient reported

Higher social support and larger social networks are strong protective factors that slow the pace of deficit accumulation in older breast cancer survivors and non-cancer controls.

Main Result

Effect estimate: aOR 0.77 (95% CI 0.65-0.92)

Abstract

Abstract Introduction: Deficit accumulation is an important construct in oncology, associated with chemotherapy toxicity, cognitive decline, quality of life, and survival. However, longitudinal patterns of deficit accumulation among cancer survivors remain poorly characterized, and the influence of social health on these trajectories is even less understood. We examined long-term deficit accumulation trajectories in older breast cancer survivors compared with non-cancer controls and evaluated the role of social health in predicting these trajectory memberships. Methods: We included 380 breast cancer survivors and 359 frequency-matched controls enrolled from 2010-2022, each with at least three annual follow-ups through 2024. Social health measures included emotional and tangible support using the Medical Outcomes Study Social Support (MOS-SS) tool, social and family well-being using the Functional Assessment of Cancer Therapy-General (FACT-G) subdomain, and social network size (number of close friends/relatives; categorized as 3 vs. ≤3). Deficit accumulation was assessed at each visit using a 46-item index. Group-based trajectory modeling identified distinct deficit accumulation patterns, and multinomial logistic regression examined predictors of trajectory membership. Results: Three trajectories were identified: 204 rapid decliners (28%; 5-year increase 0.06 0.012/year, p10-5), 362 slow decliners (49%; 0.005 increase 0.001/year, p=0.3), and 173 non-decliners (23%; 0.005 decrease -0.001/year, p=0.4). Breast cancer survivors were more likely to follow a rapid-declining trajectory than non-cancer controls. Among survivors, those who received chemotherapy were most likely to experience rapid deficit accumulation, suggesting persistent treatment-related vulnerability. Higher emotional support predicted lower odds of declining trajectories: each 10-point increase in emotional social support was associated with a 14% lower probability of being a slow decliner (aOR 0.86 0.74-1.01) and a 23% lower probability of being a rapid decliner (aOR 0.77 0.65-0.92). Higher social and family well-being similarly predicted 15% (aOR 0.85 0.73-0.99) and 21% (aOR 0.79 0.68-0.93) lower odds of being slow and rapid decliners, respectively. Having more than 3 close friends predicted a 65% lower probability of becoming a rapid decliner (aOR 0.38 0.17-0.87). Conclusions: Deficit accumulation trajectories in older women are heterogeneous, and breast cancer diagnosis and chemotherapy appear to contribute to more rapid deficit accumulation. Social health—including emotional support, social and family well-being, and larger social networks—emerged as a strong protective factor, slowing the pace of deficit accumulation among both breast cancer survivors and non-cancer controls. Citation Format: Eunji Choi, Iwalola Awoyinka, Jaeil Ahn, Tim A. Ahles, Ashley L. Artese, Traci N. Bethea, Judith E. Carroll, Harvey Jay Cohen, Heather S. Jim, Brenna C. McDonald, Zev Nakamura, Sunita Patel, James C. Root, Andrew J. Saykin, Brent Small, Ying Wang, Wanting Zhai, Jeanne S. Mandelblatt. Social support as a predictor of deficit accumulation in older breast cancer survivors and non-cancer controls abstract. In: Proceedings of the American Association for Cancer Research Annual Meeting 2026; Part 1 (Regular Abstracts); 2026 Apr 17-22; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2026;86(7 Suppl):Abstract nr 2465.

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