title: Cancer or no cancer: the influence of trait anxiety and diagnosis on quality of life with breast cancer and benign disease: a prospective, longitudinal study.
abstract: BACKGROUND
  High trait anxiety (HTA) causes an impaired quality of life (QOL) and fatigue in women with breast cancer (BC) and benign breast disease (BBD). We examined whether the lowered QOL was determined solely by the personality characteristic HTA or by the combination of personality and diagnosis.
  
  
  METHODS
  In a prospective longitudinal study, women with BC (n = 152), BBD (n = 205), or gallstone disease (GD) before laparoscopic cholecystectomy (n = 128) were included. Questionnaires concerning trait anxiety (baseline), fatigue, and QOL were completed at baseline and at 6 months. Multivariate linear regression analysis was performed to analyze the predictors for QOL at 6 months.
  
  
  RESULTS
  At 6 months QOL scores were increased in the GD group, especially in women without HTA. For women without HTA, in the BBD group the scores for fatigue and physical QOL had improved at 6 months, whereas in the BC group physical QOL and fatigue was impaired. Women with HTA scored unfavorably on fatigue and QOL. HTA was the most important factor influencing QOL.
  
  
  CONCLUSIONS
  The course of QOL and fatigue during follow-up were significantly different for each diagnosis. Particularly HTA had a negative impact on QOL and fatigue. Especially the combination HTA and BC caused impaired QOL and fatigue. We recommend identifying women with BC and HTA and offer them a tailor-made follow-up protocol.
authors.affiliation: Department of Pediatric Surgery, Beatrix Children's Hospital, University of Groningen, University Medical Centre Groningen, Hanzeplein 1, 9700 RB Groningen, The Netherlands. cmgkeyzer@hotmail.com
authors.forename: Claudia M G
authors.initials: CM
authors.lastname: Keyzer-Dekker
authors.forename: Jolanda
authors.initials: J
authors.lastname: de Vries
authors.forename: Marlies C
authors.initials: MC
authors.lastname: Mertens
authors.forename: Jan A
authors.initials: JA
authors.lastname: Roukema
authors.forename: Alida F W
authors.initials: AF
authors.lastname: van der Steeg
mesh_terms: D000328:Adult; D000368:Aged; D001007:Anxiety; D001943:Breast Neoplasms / Q000175:diagnosis / Q000523:psychology*; D017081:Cholecystectomy, Laparoscopic / Q000523:psychology; D005221:Fatigue / Q000453:epidemiology; D005260:Female; D042882:Gallstones / Q000523:psychology / Q000601:surgery; D006801:Humans; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life / Q000523:psychology*