Influence of psychological response on survival in breast cancer : a population-based cohort study.
Background The psychological response to breast cancer, such as a fighting spirit or an attitude of helplessness and hopelessness toward the disease, has been suggested as a prognostic factor with an influence on survival.
We have investigated the effect of psychological response on disease outcome in a large cohort of women with early-stage breast cancer.
Methods 578 women with early-stage breast cancer were enrolled in a prospective survival study.
Psychological response was measured by the mental adjustment to cancer (MAC) scale, the Courtauld emotional control (CEC) scale, and the hospital anxiety and depression (HAD) scale 4-12 weeks and 12 months after diagnosis.
The women were followed up for at least 5 years.
Cox's proportional-hazards regression was used to obtain the hazard ratios for the measures of psychological response, with adjustment for known clinical factors associated with survival.
Findings At 5 years, 395 women were alive and without relapse, 50 were alive with relapse, and 133 had died.
There was a significantly increased risk of death from all causes by 5 years in women with a high score on the HAD scale category of depression (hazard ratio 3.59 [95% Cl 1.39-9.24]). There was a significantly increased risk of relapse or death at 5 years in women with high scores on the helplessness and hopelessness category of the MAC scale compared with those with a low score in this category (1.55 [1.07-2.25]). (...)
Mots-clés Pascal : Tumeur maligne, Glande mammaire, Psychologie, Coping, Epidémiologie, Pronostic, Survie, Homme, Femelle, Etude comparative, Etude cohorte, Royaume Uni, Europe, Glande mammaire pathologie
Mots-clés Pascal anglais : Malignant tumor, Mammary gland, Psychology, Coping, Epidemiology, Prognosis, Survival, Human, Female, Comparative study, Cohort study, United Kingdom, Europe, Mammary gland diseases
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Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0517072
Code Inist : 002B20E02. Création : 18/05/2000.