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

  • Epidemiology
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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.

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Acknowledgements

The study was funded by the Danish Cancer Society (grant 94 150 01).

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Authors and Affiliations

  1. The Research Unit, Department of Palliative Medicine, Bispebjerg Hospital, Bispebjerg Bakke 23, 2400, Copenhagen, Denmark

    Mogens Groenvold

  2. Institute of Public Health, University of Copenhagen, 2200, Copenhagen, Denmark

    Mogens Groenvold

  3. The Research Unit, Department of Palliative Medicine, Bispebjerg Hospital, DK-2400, Copenhagen, Denmark

    Morten Aagaard Petersen

  4. Institute for Health, Health Care Policy, and Aging Research, Rutgers University, New Brunswick, NJ, 08903-5072, USA

    Ellen Idler

  5. National Institute of Occupational Health, 2100, Copenhagen, Denmark

    Jakob Bue Bjorner

  6. Department of Public Health, University of Aberdeen Medical School, Aberdeen, AB25 2ZD, UK

    Peter M. Fayers

  7. Unit of Applied Clinical Research, the Norwegian University of Science and Technology, 7006, Trondheim, Norway

    Peter M. Fayers

  8. Department of Oncology ONK, Finsen Centre, Righospitalet, 2100, Copenhagen, Denmark

    Henning T. Mouridsen

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  1. Mogens Groenvold
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Correspondence to Mogens Groenvold.

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Groenvold, M., Petersen, M.A., Idler, E. et al. Psychological distress and fatigue predicted recurrence and survival in primary breast cancer patients. Breast Cancer Res Treat 105, 209–219 (2007). https://doi.org/10.1007/s10549-006-9447-x

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  • DOI: https://doi.org/10.1007/s10549-006-9447-x

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