PSYCHONEUROIMMUNOLOGY AND THE COURSE OF BREAST-CANCER - AN OVERVIEW -THE IMPACT OF PSYCHOSOCIAL FACTORS ON PROGRESSION OF BREAST-CANCER THROUGH IMMUNE AND ENDOCRINE MECHANISMS

This review focuses upon possible mediators of the frequently noted as sociations between psychosocial factors and the progression of breast cancer. First, host-related endocrine and immunological processes that may play an important role in the carcinogenesis and progression of b reast cancer are summarized. Second, the effects of several endocrines on different components of the immune system that have been shown to be related to the course of breast cancer are addressed. Third, studie s examining the effect of psychosocial factors on immune function cond ucted with breast cancer patients and healthy individuals are describe d. Based on this review, it can be concluded that causal relations bet ween psychosocial stressors, endocrine and immune processes, and breas t cancer progression remain to be elucidated. It can be hypothesized t hat psychosocial stressors influence the course of breast cancer by mo dulating endocrine processes which are directly related to tumor growt h or indirectly related by decreasing immunologic control over tumor d evelopment and metastases. Finally, methodological pitfalls that plagu e this line of research are summarized and recommendations for future psychoneuroimmunologic research in breast cancer are provided.