Psychosocial factors and survival of young women with breast cancer: a population-based prospective cohort study

Phillips, Kelly-Anne, Osborne, Richard, Giles, Graham, Dite, Gillian, Apicella, Carmel, Hopper, John and Milne, Roger 2008, Psychosocial factors and survival of young women with breast cancer: a population-based prospective cohort study, Journal of clinical oncology, vol. 26, no. 28, pp. 4666-4671.


Title Psychosocial factors and survival of young women with breast cancer: a population-based prospective cohort study
Author(s) Phillips, Kelly-Anne
Osborne, Richard
Giles, Graham
Dite, Gillian
Apicella, Carmel
Hopper, John
Milne, Roger
Journal name Journal of clinical oncology
Volume number 26
Issue number 28
Start page 4666
End page 4671
Publisher American Society of Clinical Oncology
Place of publication Alexandria, Va.
Publication date 2008-10
ISSN 0732-183X
1527-7755
1730-8801
Summary Purpose: Most women with early-stage breast cancer believe that psychosocial factors are an important influence over whether their cancer will recur. Studies of the issue have produced conflicting results.

Patients and Methods: A population-based sample of 708 Australian women diagnosed before age 60 years with nonmetastatic breast cancer was observed for a median of 8.2 years. Depression and anxiety, coping style, and social support were assessed at a median of 11 months after diagnosis. Hazard ratios for distant disease-free survival (DDFS) and overall survival (OS) associated with psychosocial factors were estimated separately using Cox proportional hazards survival models, with and without adjustment for known prognostic factors.

Results:
Distant recurrence occurred in 209 (33%) of 638 assessable patients, and 170 (24%) of 708 patients died during the follow-up period. There were no statistically significant associations between any of the measured psychosocial factors and DDFS or OS from the adjusted analyses. From unadjusted analyses, associations between greater anxious preoccupation and poorer DDFS and OS were observed (P = .02). These associations were no longer evident after adjustment for established prognostic factors; greater anxious preoccupation was associated with younger age at diagnosis (P = .03), higher tumor grade (P = .02), and greater number of involved axillary nodes (P = .008).

Conclusion:
The findings do not support the measured psychosocial factors being an important influence on breast cancer outcomes. Interventions for adverse psychosocial factors are warranted to improve quality of life but should not be expected to improve survival.
Notes Supported by the National Health and Medical Research Council (NHMRC) of Australia (Grant No. 145604) and the United States National Institutes of Health (Grant No. RO1 CA102740-01A2). The Australian Breast Cancer Family Study was supported by the NHMRC of Australia, the New South Wales Cancer Council, the Victorian Health Promotion Foundation, and the United States National Cancer Institute, National Institutes of Health (Grant No. RFA CA-95-011), and through cooperative agreements with members of the Breast Cancer Family Registry and principal investigators. K.-A.P. is supported by the Cancer Council Victoria, John Colebatch Clinical Research Fellowship. R.H.O. is supported by an NHMRC Population Health Fellow Fellowship. J.L.H. is an Australia Fellow of the NHMRC and a Victorian Breast Cancer Research Consortium Group Leader. K.-A.P. and R.H.O. contributed equally to this work. The content of this article does not necessarily reflect the views or policies of the National Cancer Institute or of any collaborating centers in the Cancer Family Registry (CFR), nor does mention of trade names, commercial products, or organizations imply endorsement by the United States Government or the CFR. Authors’ disclosures of potential conflicts of interest and author contributions are found at the end of this article.
Language eng
Field of Research 110399 Clinical Sciences not elsewhere classified
Socio Economic Objective 970111 Expanding Knowledge in the Medical and Health Sciences
HERDC Research category C1.1 Refereed article in a scholarly journal
HERDC collection year 2008
Copyright notice ©2008, American Society of Clinical Oncology
Persistent URL http://hdl.handle.net/10536/DRO/DU:30019428

Document type: Journal Article
Collection: School of Health and Social Development
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