Predictive factors for psychological distress related to diagnosis of breast cancer
Article first published online: 2 JAN 2012
Copyright © 2012 John Wiley & Sons, Ltd.
Volume 22, Issue 3, pages 523–529, March 2013
How to Cite
Iwatani, T., Matsuda, A., Kawabata, H., Miura, D. and Matsushima, E. (2013), Predictive factors for psychological distress related to diagnosis of breast cancer. Psycho-Oncology, 22: 523–529. doi: 10.1002/pon.3023
- Issue published online: 1 MAR 2013
- Article first published online: 2 JAN 2012
- Manuscript Accepted: 27 NOV 2011
- Manuscript Revised: 21 NOV 2011
- Manuscript Received: 30 JUL 2011
- breast cancer;
- diagnostic process;
- psychological distress;
- predictive factor
The aims of the present study were as follows: (i) to clarify the proportion of women who experience psychological distress during breast cancer diagnosis and (ii) to identify the predictors of psychological distress related to the diagnostic process.
This was a longitudinal prospective study of women who required further breast examination. Questionnaires were administered at pre-medical consultations (Time 1), after describing radiological examination (Time 2), and after explaining pathological findings (Time 3). All participants completed Hospital Anxiety and Depression Scale (HADS), Functional Assessment of Cancer Therapy—Breast, and Functional Assessment of Chronic Illness Therapy—Spiritual subscale at Time 1 to identify predictors. Participants also completed HADS at Times 2 and 3 to identify the presence or absence of psychological distress.
Of the 222 eligible patients, at Time 2, 31 (22.6%) participants with no clinical abnormalities and 39 (45.9%) participants with abnormal findings had HADS scores of ≥11 points (χ2 test, 13.14; p < 0.001). At Time 3, 14 (28.0%) participants with benign breast changes and 24 (68.6%) participants with breast cancer had scores of ≥11 (χ2 test, 13.71; p < 0.001). Higher HADS scores at Time 1 were associated with the presence of psychological distress at all stages of breast cancer diagnosis. Advanced tumor stage was a predictor of psychological distress for participants with breast cancer (odds ratios = 3.314, 95% confidence interval = 1.033–9.509; p = 0.044).
These results suggest that intensive psychological intervention is necessary for breast cancer patients with large tumors, as well as for women with suspected breast cancer with high HADS scores at pre-consultation. Copyright © 2012 John Wiley & Sons, Ltd.