Do psychological factors predict survival in breast cancer?

One hundred and twenty-two women with primary operable breast cancer were interviewed before and three months after mastectomy. The outcome of 121 of the women was assessed 6-8 years after operation. Women who were regarded as having enough symptoms to fulfil the criteria for a psychiatric illness (according to Research Diagnostic Criteria (RDC) and the General Health Questionnaire (GHQ) before operation were less likely to have a recurrence during the follow-up. Those who were assessed three months after operation as coping by using a strategy of denial had a better chance of remaining recurrence-free than those women employing other coping strategies; this finding must be viewed with reservation because of the inherent difficulties in measuring coping strategies. These psychological measures improved the prediction of recurrence-free survival beyond that achieved by other variables (e.g. histological node status, tumour size and treatment).