Breast Cancer Research and Treatment

, Volume 105, Issue 2, pp 209–219

Psychological distress and fatigue predicted recurrence and survival in primary breast cancer patients

Authors

    • The Research Unit, Department of Palliative MedicineBispebjerg Hospital
    • Institute of Public HealthUniversity of Copenhagen
  • Morten Aagaard Petersen
    • The Research Unit, Department of Palliative MedicineBispebjerg Hospital
  • Ellen Idler
    • Institute for Health, Health Care Policy, and Aging ResearchRutgers University
  • Jakob Bue Bjorner
    • National Institute of Occupational Health
  • Peter M. Fayers
    • Department of Public HealthUniversity of Aberdeen Medical School
    • Unit of Applied Clinical Researchthe Norwegian University of Science and Technology
  • Henning T. Mouridsen
    • Department of Oncology ONKFinsen Centre
Epidemiology

DOI: 10.1007/s10549-006-9447-x

Cite this article as:
Groenvold, M., Petersen, M.A., Idler, E. et al. Breast Cancer Res Treat (2007) 105: 209. doi:10.1007/s10549-006-9447-x

Abstract

This study examined whether psychological distress in newly diagnosed breast cancer patients was associated with their survival. We analyzed data from 1,588 breast cancer patients who filled in the EORTC QLQ-C30 questionnaire and the Hospital Anxiety and Depression Scale (HADS) 2 months after their primary operation. The median follow-up time was 12.9 years. Psychological distress (EORTC QLQ-C30 emotional function; HADS anxiety; HADS depression) and EORTC fatigue, physical function, and overall ratings were used to predict recurrence-free and overall survival, controlling for the known clinical and histopathological prognostic factors (biological model) using Cox multivariate regression analysis. Low levels of psychological distress (good EORTC emotional function) and low fatigue independently predicted longer recurrence-free and overall survival, controlling for biological factors. Lack of anxiety (HADS) also predicted longer recurrence-free survival. When added in combination to the biological model, fatigue remained a significant predictor of recurrence-free survival (P = 0.0004; risk ratio 1.32 (1.13–1.54)) and emotional function remained a significant predictor of overall survival (P = 0.0074; risk ratio 0.81 (0.70–0.95)). Low psychological distress and a low level of fatigue may cause a greater cancer resistance or may reflect underlying mental and physical robustness.

Keywords

Breast neoplasmsSurvivalPsychological distressQuality of LifePsychoneuroimmunologyPrognostic factors

Copyright information

© Springer Science+Business Media, LLC 2006