Titre du document / Document title

Influence of psychological response on survival in breast cancer : a population-based cohort study

Auteur(s) / Author(s)

WATSON M. ^{(1 2)} ; HAVILAND J. S. ⁽²⁾ ; GREER S. ⁽³⁾ ; DAVIDSON J. ⁽²⁾ ; BLISS J. M. ⁽²⁾ ;

Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)

⁽¹⁾ Royal Marsden Hospital NHS Trust, Sutton and London, ROYAUME-UNI
⁽²⁾ Institute of Cancer Research, Sutton, ROYAUME-UNI
⁽³⁾ St Raphael's Hospice, North Cheam, Surrey, ROYAUME-UNI

Résumé / Abstract

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]). There were no significant results found for the category of fighting spirit. Interpretation For 5-year event-free survival a high helplessness/hopelessness score has a moderate but detrimental effect. A high score for depression is linked to a significantly reduced chance of survival; however, this result is based on a small number of patients and should be interpreted with caution.

Revue / Journal Title

Lancet   ISSN 0140-6736   CODEN LANCAO 

Source / Source

1999, vol. 354, n^o9187, pp. 1331-1336 (22 ref.)

Langue / Language

Anglais

Editeur / Publisher

Lancet, London, ROYAUME-UNI  (1823) (Revue)

Mots-clés anglais / English Keywords

Malignant tumor ; Mammary gland ; Psychology ; Coping ; Epidemiology ; Prognosis ; Survival ; Human ; Female ; Public health ; Comparative study ; Cohort study ; United Kingdom ; Europe ; Mammary gland diseases ;

Mots-clés français / French Keywords

Tumeur maligne ; Glande mammaire ; Psychologie ; Coping ; Epidémiologie ; Pronostic ; Survie ; Homme ; Femelle ; Santé publique ; Etude comparative ; Etude cohorte ; Royaume Uni ; Europe ; Glande mammaire pathologie ;

Mots-clés espagnols / Spanish Keywords

Tumor maligno ; Glándula mamaria ; Psicología ; Coronación ; Epidemiología ; Pronóstico ; Sobrevivencia ; Hombre ; Hembra ; Salud pública ; Estudio comparativo ; Estudio cohorte ; Reino Unido ; Europa ; Glándula mamaria patología ;

Localisation / Location

INIST-CNRS, Cote INIST : 5004, 35400008815954.0100