title: Life stress and losses and deficit in adulthood as breast cancer risk factor: a prospective case-control study in Kuopio, Finland.
abstract: BACKGROUND
  to the Authors' knowledge, the associations between the life stress and losses and deficit in adulthood and the risk of breast cancer (BC) are rarely considered together in a prospective study.
  
  
  METHODS
  in an extension of the Kuopio Breast Cancer Study, 115 women with breast symptoms were semi-structurally interviewed in-depth, as well as asked to complete standardised questionnaires, and all study variables were obtained before any diagnostic procedures were carried out. The Montgomery-Åsberg depression rating scale (MADRS) was used to evaluate the depression of the study participants.
  
  
  RESULTS
  the clinical examination and biopsy showed BC in 34 patients, benign breast disease (BBD) in 53 patients, and 28 individuals were shown to be healthy (HSS). The BC group had significantly higher mean score for the loss of social status in adulthood than did the BBD and HSS groups (p<0.05). In addition, the women in the BC group had significantly higher mean score for stress in adulthood in the previous 6-10 years (p<0.01), in the previous 2-6 years (p<0.05) and for stress in adulthood in the previous two years (p<0.05) than the women in the BBD and HSS groups. The BC group also had significantly more severe losses in adulthood than the BBD and HSS groups (p<0.01). The results indicated that breast cancer patients tended to have more life stress and losses in adulthood than did those in the BBD and HSS groups.
  
  
  CONCLUSIONS
  the results of this study support a weak association between life stress and losses in adulthood and breast cancer risk and it might be that stress and losses impacts indirectly on breast cancer risk, affecting behaviour, or directly on the hypothalamic-pituitary-adrenal axis and autonomic nervous system functioning.
authors.affiliation: School of Medicine, Surgery, University of Eastern Finland, Kuopio, Finland. matti.eskelinen@kuh.fi
authors.forename: Matti
authors.initials: M
authors.lastname: Eskelinen
authors.forename: Paula
authors.initials: P
authors.lastname: Ollonen
mesh_terms: D001601:Bereavement; D001943:Breast Neoplasms / Q000453:epidemiology* / Q000209:etiology; D016022:Case-Control Studies; D005260:Female; D005387:Finland; D006801:Humans; D011446:Prospective Studies; D012307:Risk Factors; D013315:Stress, Psychological / Q000150:complications*