title: Influence of stress related to war on biological and morphological characteristics of breast cancer in a defined population.
abstract: OBJECTIVE
  To assess differences between patients with breast cancer before, during and after the 1991-1995 war in Croatia.
  
  
  METHODS
  We analyzed 660 patients of Pozesko-Slavonska County, during the three periods. Relative predictive values of patient's characteristics and stage of tumor were assessed using the X2-test, and survival with Kaplan-Meier analysis.
  
  
  RESULTS
  Tumors were significantly more often of higher stages (IIA and IIB) and with axillary lymph node metastases (N1) during the war, than in pre-war and post-war period.Breast cancer was significantly more frequent in patients who previously experienced death in the family (35,3%). The Kaplan-Meier analysis showed correlation between survival, T and N stages of tumor and clinical stage of tumor.
  
  
  CONCLUSIONS
  The war aggression towards Croatia with its impact on our patients, contributed to modification of characteristics of breast cancer in the analyzed period.
authors.affiliation: Department of Surgery, County Hospital, Pozega, Croatia.
authors.forename: J
authors.initials: J
authors.lastname: Fajdic
authors.forename: N
authors.initials: N
authors.lastname: Gotovac
authors.forename: Z
authors.initials: Z
authors.lastname: Hrgovic
authors.forename: W J
authors.initials: WJ
authors.lastname: Fassbender
mesh_terms: D001365:Axilla; D001943:Breast Neoplasms / Q000473:pathology* / Q000523:psychology; D018567:Breast Neoplasms, Male / Q000473:pathology* / Q000523:psychology; D017523:Croatia; D003643:Death; D005260:Female; D006801:Humans; D008016:Life Change Events; D008207:Lymphatic Metastasis / Q000473:pathology; D008297:Male; D009367:Neoplasm Staging; D012189:Retrospective Studies; D013315:Stress, Psychological / Q000523:psychology*; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome; D014857:Warfare