title: Does the occurrence of adverse life events in patients with breast cancer lead to a change in illness behaviour?
abstract: OBJECTIVE
  It was examined whether life-changing events may lead to changes of illness behaviour in women prior to breast cancer diagnosis. We considered the delay in three different aspects: date of breast self-examination, routine visits at the doctor, and finally changes in the length of time intervals between the detection of suspicious breast symptoms and the subsequent verification of diagnoses.
  
  
  METHODS
  The data of 240 patients (age <70 years) with a first manifestation of breast cancer were used for analysis. Life events were assessed by means of a semi-structured interview as proposed by Brown and Harris and classified according to a system proposed by Brugha et al., the List of Threatening Experiences (LTE). All analyses were performed by means of Cox's proportional hazard regression.
  
  
  RESULTS
  Women with stressful events went to the doctor earlier than those without events. The date of breast self-examination remained unchanged after the occurrence of events. Women who had discovered suspicious breast symptoms delayed the subsequent visit at the doctor if they had experienced two serious events within this period. The occurrence of life events may have effects on illness behaviour, but into different directions.
  
  
  CONCLUSIONS
  In the majority of cases, event-related delays were shorter than those reported to aggravate the prognosis of breast cancer.
authors.affiliation: Medical Sociology Unit OE 5420, Hannover Medical School, Carl- Neuberg- Strasse 1, 30625, Hannover, Germany. geyer.siegfried@mh-hannover.de
authors.forename: Siegfried
authors.initials: S
authors.lastname: Geyer
authors.forename: Dorothee
authors.initials: D
authors.lastname: Noeres
authors.forename: Mariya
authors.initials: M
authors.lastname: Mollova
authors.forename: Heike
authors.initials: H
authors.lastname: Sassmann
authors.forename: Alexandra
authors.initials: A
authors.lastname: Prochnow
authors.forename: Mechthild
authors.initials: M
authors.lastname: Neises
mesh_terms: D000328:Adult; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000523:psychology*; D016504:Breast Self-Examination / Q000523:psychology*; D005260:Female; D006801:Humans; D055809:Illness Behavior; D007407:Interviews as Topic; D008016:Life Change Events; D008875:Middle Aged