title: Psychosocial factors and breast cancer: a 6-year Italian follow-up study.
abstract: BACKGROUND
  Over the last 20 years contradictory results have been obtained as regards to the role of psychosocial factors in favouring the onset of breast cancer and/or in influencing disease progression.
  
  
  METHODS
  The present study prospectively investigated the association between psychosocial variables and breast cancer in 95 out-patients. Within 3 months from the diagnosis the patients completed a series of questionnaires to evaluate psychological disturbances, emotional repression, adjustment to cancer, social support and occurrence of life events in the past. At a distance of 6 years from the first assessment, the patients' charts were re-examined in order to evaluate the course of cancer.
  
  
  RESULTS
  A higher volume of primary tumour at surgery was shown in patients who had had stressful events in the 6 months preceding cancer diagnosis. At follow-up, no relationship was found between psychosocial variables and the course of disease. The analysis of the frequency of relapses and deaths, and the survival analysis indicated that positivity of loco-regional lymph nodes, infiltrating histotype of the tumour and tumour stage were the only significant predictors of the time of death.
  
  
  CONCLUSIONS
  The study suggests that clinical and biological rather than psychosocial factors exert a major role in breast cancer progression.
authors.affiliation: Department of Biomedical Sciences and Technologies, University of Udine, Italy. giraldi@cc.uniud.it
authors.forename: T
authors.initials: T
authors.lastname: Giraldi
authors.forename: M G
authors.initials: MG
authors.lastname: Rodani
authors.forename: G
authors.initials: G
authors.lastname: Cartei
authors.forename: L
authors.initials: L
authors.lastname: Grassi
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D001294:Attitude to Health; D001943:Breast Neoplasms / Q000401:mortality / Q000523:psychology*; D016009:Chi-Square Distribution; D016001:Confidence Intervals; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008016:Life Change Events; D008198:Lymph Nodes / Q000473:pathology; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012189:Retrospective Studies; D013315:Stress, Psychological / Q000150:complications*; D016019:Survival Analysis; D015996:Survival Rate