Epidemiological evidence for a relationship between life events, coping style, and personality factors in the development of breast cancer.
OBJECTIVE
Review empirical evidence for a relationship between psychosocial factors and breast cancer development.


METHODS
Standardised quality assessment criteria were utilised to assess the evidence of psychosocial predictors of breast cancer development in the following domains: (a) stressful life events, (b) coping style, (c) social support, and (d) emotional and personality factors.


RESULTS
Few well-designed studies report any association between life events and breast cancer, the exception being two small studies using the Life Events and Difficulties Schedule (LEDS) reporting an association between severely threatening events and breast cancer risk. Seven studies show anger repression or alexithymia are predictors, the strongest evidence suggesting younger women are at increased risk. There is no evidence that social support, chronic anxiety, or depression affects breast cancer development. With the exception of rationality/anti-emotionality, personality factors do not predict breast cancer risk.


CONCLUSIONS
The evidence for a relationship between psychosocial factors and breast cancer is weak. The strongest predictors are emotional repression and severe life events. Future research would benefit from theoretical grounding and greater methodological rigour. Recommendations are given.
Butow
P N
PN
Department of Psychological Medicine, Royal North Shore Hospital, and University of Sydney, NWS 2065, Australia. phyllisb@med.usyd.edu.au
Hiller
J E
JE
Price
M A
MA
Thackway
S V
SV
Kricker
A
A
Tennant
C C
CC
D000223:Adaptation, Psychological; D001943:Breast Neoplasms / Q000453:epidemiology* / Q000523:psychology*; D016021:Epidemiologic Studies; D005260:Female; D006801:Humans; D008016:Life Change Events; D010551:Personality; D010555:Personality Inventory; D012307:Risk Factors; D013315:Stress, Psychological