Hearing/vestibular dysfunction and longitudinal changes in psychosocial well-being among breast cancer survivors.

Abstract

12084 Background: Breast cancer treatment, in some cases, can cause hearing/vestibular dysfunction and negatively affect patients’ quality of life. The breast cancer survivor population is both growing and aging. Despite evidence that other cancer survivors have higher rates of hearing/vestibular problems than the general population, little is unknown about the impact of hearing/vestibular dysfunction on long-term changes in psychosocial well-being (PSWB) among breast cancer survivors. Methods: We surveyed the Chicago Multiethnic Epidemiologic Breast Cancer Cohort regarding whether patients had ever been told by a doctor that they had tinnitus, hearing loss, and/or vertigo between July and September 2023. PSWB was assessed repeatedly using the 10-item PROMIS on psychological distress/social isolation in 2020, 2021, 2022, and 2025. Total scores range from 0 to 40, with higher scores reflecting better PSWB. We fit separate linear mixed-effects models for hearing/vestibular dysfunction, controlling for age, race/ethnicity, marital status, income, insurance, comorbidity, AJCC stage, and treatment modality. Adjusted coefficients ( β ) and 95% CIs were calculated. Results: 1,466 breast cancer survivors were included: the mean age at survey was 63.5 years (SD 11.7); 69.6% identified as White, 22.6% as Black, 3.7% as Asian or Pacific Islander, and 3.6% as Hispanic. Overall, 16.5%, 17.4%, and 8.6% had tinnitus, hearing loss, and vertigo, respectively. The distribution of PSWB scores and trend over time are presented in the table. Survivors with hearing/vestibular dysfunction had lower mean scores than those without. After covariate adjustment, tinnitus ( β –1.12; 95% CI –1.93, –0.30), hearing loss ( β –1.12; 95% CI –1.93, –0.30), and vertigo ( β –1.34; 95% CI –2.44, –0.24) were associated with significantly lower PSWB scores. In all subgroups, the PSWB score increased significantly over the years. Furthermore, Hispanic ethnicity, Medicaid, and being single were correlated with lower scores; whereas higher income levels were associated with higher scores. Conclusions: In this diverse cohort, breast cancer survivors with hearing/vestibular dysfunction experienced suboptimal PSWB over the study period. PSWB also varied by socioeconomic status. Oncology programs should consider screening for hearing/vestibular dysfunction and unmet sensory healthcare needs to improve PSWB and quality of life among breast cancer survivors. PSWB score, mean (SD) Tinnitus Hearing loss Vertigo Survey year No Yes No Yes No Yes 2020 28.7 (6.0) 28.4 (6.0) 28.8 (6.0) 28.2 (5.9) 28.7 (6.0) 28.3 (6.1) 2021 29.4 (5.6) 28.9 (5.9) 29.4 (5.6) 29.0 (5.5) 29.5 (5.6) 27.8 (6.0) 2022 30.1 (5.6) 29.2 (6.1) 30.0 (5.7) 29.7 (6.0) 30.1 (5.6) 28.5 (6.5) 2025 33.3 (5.6) 32.1 (6.4) 33.3 (5.6) 32.4 (6.2) 33.2 (5.6) 31.8 (6.3) Trend per year ( p -value) 0.89 (<0.001) 0.75 (<0.001) 0.87 (<0.001) 0.86 (<0.001) 0.89 (<0.001) 0.66 (<0.001)