title: Stress Exposure in Significant Relationships Is Associated with Lymph Node Status in Breast Cancer.
abstract: OBJECTIVE
  Life stress exposure may impact on health and disease. Previous literature showed that stressful life events are associated with cancer incidence, survival and mortality. In animal models, patterns of maternal care have been shown to critically affect stress sensitivity and immunity trajectories later in life, by modifying DNA methylation during critical periods early in life. However, the role of parental care in breast cancer progression and survival has only limitedly been explored. Here, we investigated whether these factors may be linked to biological prognostic variables.
  
  
  METHODS
  One hundred twenty-three women hospitalized for surgery of primary breast cancer completed a questionnaire assessing parental bonding. Stressful events throughout the life span were also assessed.
  
  
  RESULTS
  We found that the absence of optimal parental relationships is significantly associated with an increased risk of lymph node involvement, adjusting for confounders, while cumulative stress in the area of sentimental relationships is borderline significantly associated with the same prognostic factor.
  
  
  CONCLUSIONS
  Our results suggest that parental bonding and sentimental relations may have a role in breast cancer progression. These variables represent an important evolutionary aspect which may modulate cancer progression through psycho-physiological stress pathways and influence the immune system.
authors.affiliation: Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology, Milan, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Renzi
authors.affiliation: Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology, Milan, Italy.
authors.forename: Valeria
authors.initials: V
authors.lastname: Vadilonga
authors.affiliation: Division of Epidemiology and Biostatistics, European Institute of Oncology, Milan, Italy.
authors.forename: Sara
authors.initials: S
authors.lastname: Gandini
authors.affiliation: Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology, Milan, Italy.
authors.forename: Giada
authors.initials: G
authors.lastname: Perinel
authors.affiliation: Division of Epidemiology and Biostatistics, European Institute of Oncology, Milan, Italy.
authors.forename: Nicole
authors.initials: N
authors.lastname: Rotmensz
authors.affiliation: Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology, Milan, Italy.
authors.forename: Florence
authors.initials: F
authors.lastname: Didier
authors.affiliation: Immunobiology of Dendritic Cells and Immunotherapy Unit, European Institute of Oncology, Milan, Italy.|Department of Oncology and Hemato-oncology, University of Milan, Milan, Italy.
authors.forename: Maria
authors.initials: M
authors.lastname: Rescigno
authors.affiliation: Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology, Milan, Italy.|Department of Oncology and Hemato-oncology, University of Milan, Milan, Italy.
authors.forename: Gabriella
authors.initials: G
authors.lastname: Pravettoni
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000473:pathology* / Q000523:psychology*; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D010290:Parents; D013315:Stress, Psychological; D011795:Surveys and Questionnaires