Association of patient-reported stress and pain with survival in nonmetastatic breast cancer: secondary analysis of Alliance A011502

To evaluate the prognostic role of patient-reported outcomes (PROs) in nonmetastatic breast cancer, we conducted secondary analysis of 2763 women in A011502, a randomized trial of adjuvant aspirin vs. placebo. High stress (Perceived Stress Scale) was associated with worse invasive disease-free survival (iDFS) (adjusted hazard ratio (aHR) 2.22) and distant recurrence-free survival (DRFS) (aHR 2.3). Moderate/severe pain (Brief Pain Inventory) predicted worse iDFS (aHR 1.67), DRFS (aHR 1.83), distant recurrence-free interval (aHR 1.53) and overall survival (aHR 2.21). PROs may enhance risk stratification in survivorship care. Trial Registration: ClinicalTrials.gov: NCT02927249.