NEW YORK (Reuters Health) - Most older women who survive breast cancer maintain their emotional well-being, though some are at greater risk of a change for the worse, a new study suggests.

Researchers found among a large group of older women they followed for 5 years after breast cancer surgery that the majority showed little change in various measures of emotional health. Some, however, were more likely to suffer a decline -- including women who'd initially believed they wouldn't be cured.

In contrast, women who felt they had strong support from family and friends, or good communication with their doctor, were less likely to show declines in their emotional well-being.

The investigators led Dr. Kerri M. Clough-Gorr of Boston University Medical Center report the findings in the Journal of Clinical Oncology.

Research has suggested that younger women are at relatively greater risk of long-term emotional distress after a breast cancer diagnosis, but older women are certainly not immune. Yet little is known about the factors that make some older women more vulnerable to declines in emotional health, according to Clough-Gorr and her colleagues.

Their study involved 660 U.S. women age 65 and older who'd been treated for early breast cancer. At regular intervals for up to 5 years, the women were interviewed about their emotional well-being, physical functioning and feelings about their support from their family, friends and health providers.

Throughout that time, the study found, the majority of the women maintained their emotional health, particularly those who were initially in better physical health, had a stronger support system or felt good about their communication with their doctor.

In contrast, women who were initially pessimistic about their chances of survival showed poorer emotional health in the years after their diagnosis. The same was true of women with less education.

The findings, according to Clough-Gorr and her colleagues, suggest ways to aid women's long-term emotional well-being after breast cancer -- better communication on the part of doctors being one.

"How doctors interact with their patients seems to have an enduring effect on how women cope with cancer-specific issues over time," the researchers note.

Another key, they add, is having family members and friends to talk to, and to help with personal problems. Interventions to teach family members how to give such emotional support might "buffer the impact" of a breast cancer diagnosis, and improve older women's long-term emotional health.