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Ultrasonographic Evaluation of Breast Cancer-related Lymphedema
Published on: January 12, 2017
Allostatic Load Predicts Symptom Burden Among Breast Cancer Survivors.
Yufan Guan1, Jie Shen1, Joseph Boyle2
1University of Virginia.
Research Square
|May 25, 2026
Summary
Allostatic load, a measure of cumulative physiological stress, is linked to worse physical and mental health outcomes in breast cancer survivors. This chronic stress also contributes to socioeconomic disparities in symptom burden, highlighting a potential intervention target.
Area of Science:
- Oncology
- Psychoneuroimmunology
- Public Health
Background:
- Breast cancer survivors often experience persistent, co-occurring physical and mental health symptoms.
- The role of allostatic load (AL), a measure of cumulative physiological stress, in survivorship outcomes is not well understood.
Purpose of the Study:
- To examine the associations of allostatic load with physical and mental health outcomes, symptom burden profiles, and socioeconomic disparities in breast cancer survivors.
- To investigate allostatic load as a potential mediator of socioeconomic disparities in survivorship outcomes.
Main Methods:
- Utilized UK Biobank data from 1,444 breast cancer survivors and 1,444 matched controls.
- Allostatic load was calculated from 11 biomarkers.
- Latent class analysis, multivariable regression, and mediation analyses were performed to assess outcomes including sleep quality, fatigue, depression, anxiety, cognitive function, and functional limitation.
Main Results:
- Higher allostatic load was significantly associated with poorer sleep quality, increased fatigue, greater functional limitation, higher depressive and anxiety symptoms, and worse self-rated mental health in breast cancer survivors.
- These associations were weaker or absent in the control group.
- Allostatic load partially mediated the relationship between socioeconomic factors (income, education) and adverse survivorship outcomes, accounting for 6-15% of the variance.
Conclusions:
- Elevated allostatic load is associated with a higher burden of physical and mental health symptoms post-breast cancer treatment.
- Chronic physiological stress, as measured by allostatic load, contributes to socioeconomic disparities in breast cancer survivorship.
- Targeting physiological stress mechanisms may improve survivorship heterogeneity and reduce health disparities.
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