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Health Locus of Control (HLOC) and other predictors of Quality of Life (QL) were examined for women with an initial versus recurrent breast cancer diagnosis. Twenty-eight women with an initial breast cancer (IBC) diagnoses and twenty-eight women with recurrent breast cancer (RBC) diagnoses were recruited from doctors' offices and cancer support groups. Correlational analyses were used to assess the relationships between variables. No significant differences were found between women with IBC and RBC on Psychological QL. Doctor HLOC and Psychological QL were related for women with RBC (r = .481, p = .01) and marginally so for women with IBC (r = .329, p = .09). A positive correlation was also found between Doctor HLOC and Functional QL for both women with IBC (r = .464, p = .01) and women with RBC (r = .390, p = .04). After controlling for stage of cancer, women with RBC reported higher Functional QL than did women with IBC. Advanced (stages III or IV) versus early (stages I or II) cancer stage related to lower Functional QL, controlling for initial versus recurrent diagnosis (r = -.283, p = .01). A marginally significant relationship was also found for cancer stage, regardless of initial versus recurrent diagnosis, with higher Overall QL for women with early stages of breast cancer (r = -.157, p = .09). No significant differences in Optimism or Overall QL were found between women with IBC versus RBC. No differences were found between married and single women. This research begins to explore differences in Quality of Life for women with a new versus a recurrent breast cancer diagnosis.

The purpose of the present study was to examine the role that specific factors play in the quality of life (QL) for women with recurrent breast cancer.

African American breast cancer survivors (N=22) in this exploratory study had a mean of 15.55 years since diagnosis (SD=10.734, min-5 years, max= 47 years). The women reported good quality of life, good health, good health care, very good provider care, very good sensitivity by their provider for their being a cancer survivor, and very good sensitivity and competence by their provider for treating them as an African American breast cancer survivor. Both the quantitative and qualitative data reinforce each other, showing evidence of posttraumatic growth from breast cancer, including a significant increase from before breast cancer to after breast cancer in their spirituality. Perhaps, most importantly, this exploratory study with a small sample found suggestive positive correlations between two types of self-efficacy coping and quality of life: i.e., the higher the rating for quality of life, then the greater the use of problem focused coping (r=.798, p=.000), and greater the use of support from friends/family coping (r=.776, p=.000). Hence, coping emerges as vital with regard to achieving a higher quality of life. This is consistent with Gaston-Johansson et al. (2013), urging exposing women to a Comprehensive Coping Strategy Program (CCSP). As an implication of this study, such a focus on coping strategies is recommended for health educators in their work with breast cancer survivors, and also with the newly diagnosed. While women may emerge from a breast cancer diagnosis with greater spirituality and having discovered they are stronger than they think, there may be those women who are struggling. They have yet to achieve the key factors associated with a higher quality of life such as high self-efficacy to cope with stress. Thus, health educators are advised to ensure that African American breast cancer survivors and those newly diagnosed receive culturally tailored interventions designed to improve their self-efficacy to cope. Health educators may conduct support groups with survivors and newly diagnosed women, so as to ensure they have adequate social support—especially if spousal/partner support is not high. This may counter the tendency of some women to withdraw and isolate, as per the emergent theme: emotional numbing, withdrawing, and isolating.