Shortcut Navigation:

African-American Women Experience Unique Survivorship Outcomes

When compared to those without breast cancer, those with the disease report more hot flashes, sleeping problems

March 18, 2013

Written By Nicole Katze, MA, Editor and Manager, Content Development
Reviewed By Frances K. Barg, PhD

A study published in Cancer Nursing found that African-American women with breast cancer reported more fatigue, worse hot flashes and worse sleep quality than African-American women without cancer. Yet overall, both groups of women reported nearly the same level of social support, emotional distress and life satisfaction.

Study Background

A 2008 report analyzed quality of life of African-American women with breast cancer using the findings of 26 past studies. Though the comprehensive review identified specific health-related quality-of-life issues for African-American women, a weakness in the data was that some studies compared African-American women to women of other races, or used no comparison group at all.

To strengthen the findings, the current researchers compared a group of African-American women with breast cancer to a group of African-American women without cancer.

Study Design

The researchers recruited 140 women from cancer clinics, by medical record or through community events such as support groups or fundraisers, or who asked to participate on their own. Women without breast cancer were recruited from the same community events. Of the total, 62 were African-Americans with breast cancer, and 78 were African-Americans without cancer.

Using surveys the women filled out themselves, the researchers collected information on age, education, marital status, income, health insurance coverage, body mass index (BMI), time since diagnosis, cancer stage, and the type of surgery and adjuvant therapy received. The surveys were returned by mail, and any medical information was verified through medical records.

The women rated their experiences within three categories of quality-of-life concerns, using numerical scales specific to each area of concern:

  • Disease-specific functioning scales were attention, the ability to follow through on plans or finish projects; fatigue, a constant feeling of tiredness or exhaustion; hot flashes; and stress
  • General physical, psychological and role functioning scales were quality of sleep; how much health limited physical activity; social support; and spirituality
  • Affective states were depression and positive life change

Women also rated their overall life satisfaction.


Overall, certain quality-of-life concerns were rated more significant to African-American women with breast cancer when compared to peers without cancer, the survey showed. These concerns include:

  • more fatigue
  • worse hot flashes
  • worse sleep quality

However, the women with cancer also reported some positive outcomes more than their peers without cancer, such as:

  • higher rates of partner/social support
  • more positive life change

There were no significant differences between groups in:

  • attention
  • stress level
  • maintaining physical activity
  • symptoms of depression
  • overall well-being and life satisfaction

Because the group of women with breast cancer reported some positive outcomes, the researchers believe both the women with and without disease have generally the same level of overall well-being and life satisfaction. But because these findings look only at large groups, they do not speak to the experiences of any individual woman.

What This Means For You

This study offers insight into the health-related outcomes of some African-American women. Understanding how specific groups of women are impacted by individual side effects may help healthcare providers to give more focused, tailored care.

If you are coping with post-treatment side effects, this study may reassure you that you are not alone. Many other African-American women share your concerns.

The researchers identified past studies that showed African-American women both with and without cancer report more hot flashes than women of other races. Because hot flashes often contribute to worse sleep and more fatigue, understanding the impact of hot flashes on African-American women may help nurses and care providers find ways to help you manage them. Download our Understanding guides on Insomnia and Fatigue and Hormonal Therapy to learn more about these side effects and get tips for discussing them with your healthcare providers.

Von Ah, Diane M., Russell, Kathleen M., et al. Health-Related Quality of Life of African American Breast Cancer Survivors Compared With Healthy African American Women. Cancer Nursing (2012) 35 (5): 337-346.