title: Coping response and survival in breast cancer patients: a new analysis.
abstract: OBJECTIVE
  The purpose of this study was to analyse the impact of coping response on survival of breast cancer by using a new method of assessing coping.
  
  
  METHODS
  Adjustment to cancer was assessed using a revised measure in a large cohort of breast cancer patients (N = 578) followed up over a period of 10 years. Impact of coping response measured early in the disease process (<4 months from primary diagnosis of early-stage breast cancer) was assessed, and survival analyses were undertaken including known clinical staging data and cancer treatment details.
  
  
  RESULTS
  After 5 years of follow-up from primary diagnosis, the effect of prior 'negative adjustment' was statistically significantly linked to increased risk of death and relapse of breast cancer, and for the 10-year analysis, this result remained for both risk of death and relapse. There was no statistically significant effect on survival of the novel 'positive adjustment' response.
  
  
  CONCLUSIONS
  Coping with cancer was assessed using a new methodology and is linked to an adverse impact of negative adjustment on overall survival. Positive adjustment was unrelated to survival. The current study strengthens previous evidence that there is a link between survival and coping response. The question remains of how coping response might affect physical outcome. It is considered that coping response likely impacts survival through the mediating effects on lifestyle and health behaviour that may contribute to an adverse prognosis.
authors.affiliation: Royal Marsden NHS Foundation Trust, Sutton, UK. maggie.watson@rmh.nhs.uk
authors.forename: M
authors.initials: M
authors.lastname: Watson
authors.forename: J
authors.initials: J
authors.lastname: Homewood
authors.forename: J
authors.initials: J
authors.lastname: Haviland
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000523:psychology*; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D011379:Prognosis; D016019:Survival Analysis; D017741:Survivors / Q000523:psychology*