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Does Subjective Burden of Early Breast Cancer and its Treatment Affect Immune Measures During Adjuvant Therapy?

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Abstract

Psychosocial factors have been described as affecting cellular immune measures in healthy subjects. In patients with early breast cancer we explored bi-directional psycho-immune effects to determine whether subjective burden has an impact on immune measures, and vice versa.

Patients (n= 239) operated for early breast cancer and randomized into International Breast Cancer Study Group (IBCSG) adjuvant clinical trials were assessed immediately before the beginning of adjuvant treatment (baseline) and 3 and 6 months thereafter, at the beginning of the corresponding treatment cycle. Cellular immune measures (leukocytes, lymphocytes, lymphocyte subset counts), markers of activation of the cellular immune system (β 2-microglobulin, soluble interleukin–2 receptor serum levels), and self-report subjective burden (global indicators of physical well-being, mood, coping effort) were assessed concurrently. The relationship between subjective burden and gradients of immune measures was investigated with regression analyses controlling for adjuvant treatment. There was a pattern of small negative associations between all variables assessing subjective burden before the beginning of adjuvant therapy with the gradients of the markers of activation of the cellular immune system and NK cell counts. In particular, better mood predicted a decline in the course of β 2-microglobulin and IL-2r at months 3 and 6. The gradient of β 2-microglobulin was associated with mood and coping effort at month 3. However, the effect sizes were very small. In conclusion, in this explorative investigation, there was an indication for subjective burden affecting and being affected by markers of activation of the cellular immune system during the first 3 and 6months of adjuvant therapy. The question of clinical significance remains unanswered. These associations have to be investigated with refined assessment tools and schedules.

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Authors and Affiliations

  1. Medical Division Lory-Haus, University Hospital, Inselspital, CH-3010, Berne, Switzerland

    Marzio E.E. Sabbioni

  2. IBCSG/SIAK Coordinating Center, Berne

    Jürg Bernhard

  3. Kirchlindach

    Hans-Peter Siegrist

  4. IBCSG/SIAK Coordinating Center, Berne

    Shu-Fang Hsu Schmitz & Monica Castiglione Gertsch

  5. Department of Internal Medicine, Division Oncology/Hematology, Kantonsspital, St. Gallen

    Beat Thürlimann

  6. Department of Gynecology, University Hospital Geneva, Geneva

    Hervé Bonnefoi

  7. Department of Oncology, University Hospital Lausanne, Lausanne

    Lucien Perey

  8. Oncology Division, University Hospital Basel, Basel

    Richard Herrmann

  9. Istituto Oncologico della Svizzera Italiana (IOSI), Ospedale Civico, Lugano

    Aron Goldhirsch

  10. Bürgerspital, St. Gallen, Switzerland

    Christoph Hürny

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  1. Marzio E.E. Sabbioni
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Sabbioni, M.E., Bernhard, J., Siegrist, HP. et al. Does Subjective Burden of Early Breast Cancer and its Treatment Affect Immune Measures During Adjuvant Therapy?. Breast Cancer Res Treat 87, 75–86 (2004). https://doi.org/10.1023/B:BREA.0000041584.53863.a7

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  • DOI: https://doi.org/10.1023/B:BREA.0000041584.53863.a7

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