Abstract B139: Clinical and psychosocial determinants of health-related quality of life among women with breast cancer in Puerto Rico: Domain-specific findings using the Functional Assessment of Cancer Therapy-General (FACT-G)

Abstract

Clinical and psychosocial factors influence health-related quality of life (HRQoL) among women with breast cancer; however, their contributions to specific HRQoL domains remain insufficiently characterized in Hispanic populations. This study evaluated the associations of cancer stage, perceived social support (PSS), and cardiometabolic disease with overall and domain-specific HRQoL among women with breast cancer in Puerto Rico. This secondary analysis used data from the cross-sectional START-PR study conducted between November 2023 and August 2025. Of the 871 participants recruited, 136 women met the eligibility criteria for this analysis. The Functional Assessment of Cancer Therapy-General (FACT-G) was used to assess overall HRQoL and four domains: Physical, Social/Family, Emotional, and Functional Well-Being. Cardiometabolic disease was assessed as the presence of diabetes, hypertension, heart disease, and/or kidney disease, whereas an adapted Multidimensional Scale of Perceived Social Support questionnaire was used to measure PSS. Multivariable linear regression and moderation analyses were performed, adjusting for cancer stage, PSS, age, active cancer treatment status, and cardiometabolic disease. Most participants had localized disease (67.6%) and were receiving active cancer treatment at enrollment (91.2%). The median FACT-G score was 78 (interquartile range [IQR], 61–90). In adjusted analyses, distant-stage disease was associated with significantly lower overall HRQoL (B =−14.42, 95% confidence interval [CI]: −26.12 to −2.71), whereas greater PSS was independently associated with higher overall HRQoL (B = +1.25, 95% CI: 0.93 to 1.58). Cardiometabolic disease was not associated with overall HRQoL (B = −3.53, 95% CI: −9.34 to 2.28). In HRQoL domain-specific analyses, distant-stage disease was associated only with lower Physical Well-Being (B =−7.21, 95% CI: −11.94 to −2.47), whereas PSS was positively associated with all four HRQoL domains. The multivariable linear regression model explained 72% of the variation (R2 = 0.722) of Social/Family Well-Being. Cardiometabolic disease was associated with lower Physical Well-Being (B = −2.44, 95% CI: −4.79 to −0.09) but higher Social/Family Well-Being (B = 1.54, 95% CI: 0.43to 2.64). No significant interaction between cancer stage and PSS was observed. Perceived social support was the strongest predictor of overall and domain-specific HRQoL, whereas advanced cancer stage primarily affected physical well-being. Cardiometabolic disease was associated with selected HRQoL domains but not overall HRQoL. These findings support integrating psychosocial assessment and cardiometabolic management into survivorship care to improve HRQoL among women with breast cancer in Puerto Rico and other Hispanic populations. Amanda Jones-Rodriguez, Sherily Pereira-Morales, Noemy Diaz-Ramos, Lorena Gonzalez-Sepulveda, Marievelisse Soto-Salgado. Clinical and psychosocial determinants of health-related quality of life among women with breast cancer in Puerto Rico: Domain-specific findings using the Functional Assessment of Cancer Therapy-General (FACT-G) [abstract]. In: Proceedings of the 19th AACR Conference on the Science of Cancer Health Disparities; 2026 Oct 18-21; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2026;35(10 Suppl):Abstract nr B139.