title: Effects of life event stress and social support on the odds of a >or= 2 cm breast cancer.
abstract: OBJECTIVE
  To examine the contribution of life event and social support factors to diagnosis with a >or= 2 cm breast cancer.
  
  
  METHODS
  We studied 1,459 Australian women aged 40-69 diagnosed in 2002-2003 with a first primary invasive breast cancer 1.1 cm or larger. We measured stressful life events, perceived stress levels, and social support in the year before diagnosis and collected information on other potential risk factors and confounders.
  
  
  RESULTS
  The odds of a >or= 2 cm breast cancer relative to a 1.1-1.9 cm breast cancer were reduced in women who reported tension or change in an intimate relationship in the year before diagnosis (OR=0.71 95% CI 0.54-0.92; p=0.009); the reduction was greatest in women living with a partner (OR=0.64 95% CI 0.47-0.88; p=0.006) and was largely unaffected by adjustment for other variables independently associated with a >or= 2 cm breast cancer in our study. There was no evidence that the total number or severity of all studied life events influenced cancer size. Low partner support increased the odds of a >or= 2 cm cancer but only in women not living with a partner.
  
  
  CONCLUSIONS
  Intimate relationship stress may reduce risk of a >or= 2 cm breast cancer. Suppression by stress of estrogen synthesis and metabolism is a possible mechanism.
authors.affiliation: School of Public Health, University of Sydney, Edward Ford Building A27, Sydney, NSW 2006, Australia. annek@health.usyd.edu.au
authors.forename: Anne
authors.initials: A
authors.lastname: Kricker
authors.forename: Melanie
authors.initials: M
authors.lastname: Price
authors.forename: Phyllis
authors.initials: P
authors.lastname: Butow
authors.forename: Chris
authors.initials: C
authors.lastname: Goumas
authors.forename: Jane E
authors.initials: JE
authors.lastname: Armes
authors.forename: Bruce K
authors.initials: BK
authors.lastname: Armstrong
mesh_terms: D000328:Adult; D000368:Aged; D001315:Australia / Q000453:epidemiology; D001943:Breast Neoplasms / Q000209:etiology / Q000473:pathology* / Q000523:psychology*; D016001:Confidence Intervals; D015986:Confounding Factors, Epidemiologic; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008016:Life Change Events; D008327:Mammography; D008403:Mass Screening; D008875:Middle Aged; D009367:Neoplasm Staging; D016017:Odds Ratio; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D012650:Self Disclosure; D012944:Social Support; D013315:Stress, Psychological / Q000150:complications*; D011795:Surveys and Questionnaires; D014505:Urban Population