“This study suggests that more efficacious breast cancer patients with respect to coping are better adjusted to their disease than those who report having lower levels of coping efficacy,” wrote the authors.

These results suggest a more complex relationship than congruence of perception in coping moderates adjustment to breast cancer.

Additionally, research to establish evidence-based approaches to improve alignment of congruence of perception harbors the potential to improve adjustment to disease, which could affect outcomes.

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“In order to more clearly understand the husbands’ basis for judging wives’ coping and contributions to their wives’ adjustment, future research may benefit from focusing on the sources of coping efficacy judgments made by husbands and wives and on the couple as the primary unit of study,” the authors concluded.

Sexual Minority Populations

Sexual minority (lesbian, bisexual) female patients with breast cancer face increased distress during treatment and experience inferior clinical outcomes, even when partnered. A 2012 study assessed age-adjusted relative-risk of mortality of female patients (n = 693) cohabiting with female partners vs female patients (n = 136,174) cohabiting with male partners, revealing a 3.2 times relative risk of fatal breast cancer.2

This study assessed data collected from interviews between 1997 and 2003 in the National Health Interview Survey on female patients with breast cancer aged 18 to 80 and cohabiting with a female or male partner. These data were linked to the National Death Index to determine mortality status as of December 31, 2006.

The overall risk of mortality was the same between the 2 patient groups, but the age-adjusted relative risk of mortality was a staggering 3.2 times higher in patients in same-sex relationships.

Though the support of a spouse or partner generally improves outcomes in patients with breast cancer, these results point to a discouraging disparity, the nature of which merits further research. “Despite an awareness for more than a decade that lesbian and bisexual women are likely to experience increased risk for breast cancer, the United States currently lacks a public health data strategy to determine if this is so,” the authors concluded.2

Indeed, research is lacking into the reasons why sexual minority patients are at increased risk of developing breast cancer and dying from it, and the role a partner plays in affecting outcomes is also poorly understood.

A 2012 qualitative study interviewed 15 women with nonmetastatic breast cancer diagnosed between 2000 and 2005. These female patients were living with same-sex partners.3

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Results indicated same-sex partners were the most important sources of support for patients. However, according the patients’ perspectives, partners also experienced increased distress and burden. Nonetheless, patients often expressed the value of support that comes with “sharing a life beyond cancer.”3

Unfortunately, with a dearth of objective research on how spousal and partner support may affect survivorship and outcomes in sexual minority patients, the factors affecting this patient population remain poorly understood.


1. Merluzzi TV, Martinez Sanchez M. Husbands’ perceptions of their wives’ breast cancer coping efficacy: testing congruence models of adjustment. Cancer Manag Res. 2018;10:297-304.

2. Cochran SD, Mays VM. Risk of breast cancer mortality among women cohabiting with same sex partners: findings from the National Health Interview Survey, 1997-2003. J Womens Health (Larchmt). 2012;21(5):528-533.

3. White JL, Boehmer U. Long-term breast cancer survivors’ perceptions of support from female partners: an exploratory study. Oncol Nurs Forum. 2012;39(2):210-217.