Stress response syndromes in women undergoing mammography: a comparison of women with and without a history of breast cancer.
OBJECTIVE
The purpose of this study was to assess the incidence, severity, and correlates of acute stress responses in women undergoing diagnostic mammographic surveillance and to explore the moderating impact of physician support on these symptoms.


METHODS
Sixty-six female breast cancer outpatients (at least 12 months after diagnosis and primary treatment) and 69 healthy women undergoing mammographic surveillance completed measures of: acute stress response, somatization, trauma history, psychiatric history, social support, and physician satisfaction.


RESULTS
Previous cancer, pre-mammography breast complaints, lower income, previous psychiatric medication use, greater instrumental support, greater somatization, greater perceived physician disengagement, and less perceived physician support were all associated with increased stress responses. Among women with a previous cancer diagnosis, those with greater distress reported higher levels of physician support. In contrast, among those without a previous cancer diagnosis, those with greater perceived physician support reported less distress.


CONCLUSIONS
These findings suggest that cancer-related cues, such as follow-up surveillance, may trigger a sensitizing response in women with a previous cancer diagnosis. The association of distress with physician support may arise from the responsiveness of physicians to identified distress, from increased help-seeking behavior by those who are distressed, or both. The benefit of support provided by health care professionals to those at risk of developing stress response syndromes deserves further study.
Gurevich
Maria
M
Psychosocial Oncology and Palliative Care Program, Princess Margaret Hospital, Toronto, Ontario, Canada. mgurevic@ryerson.ca
Devins
Gerald M
GM
Wilson
Christine
C
McCready
David
D
Marmar
Charles R
CR
Rodin
Gary M
GM
D000208:Acute Disease; D000328:Adult; D000367:Age Factors; D000368:Aged; D001943:Breast Neoplasms / Q000000981:diagnostic imaging / Q000523:psychology*; D003463:Cues; D005260:Female; D006801:Humans; D007182:Income; D008327:Mammography / Q000523:psychology*; D001523:Mental Disorders / Q000150:complications / Q000188:drug therapy; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging / Q000523:psychology; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D012944:Social Support; D012959:Socioeconomic Factors; D013001:Somatoform Disorders / Q000209:etiology / Q000523:psychology; D013315:Stress, Psychological / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D011795:Surveys and Questionnaires; D013577:Syndrome