Anxiety and adherence to breast self-examination in women with a family history of breast cancer

Objective: Previous research has indicated low rates of adherence to monthl y breast self-examination (BSE) in women with a family history of breast ca ncer, and anxiety has been identified as a major factor that may interfere with regular self-examination. However, the direction of the relationship b etween anxiety and BSE frequency remains unclear, with some studies indicat ing that high anxiety promotes adherence and others indicating that it lead s to avoidance. The aim of the present study was to clarify the relationshi p between anxiety and adherence to breast self-examination by comparing the impact of general anxiety with that of cancer-specific anxiety on BSE freq uency. Methods: A sample of at-risk women (N = 833) completed a questionnai re regarding BSE frequency, general anxiety, breast cancer worries, perceiv ed risk of breast cancer, and family history of breast cancer. Women who se lf-examined infrequently (N = 211), appropriately (N = 462), or excessively (N = 156) were compared on these variables. Results: Statistical analyses indicated that general anxiety differentiated only between excessive self-e xaminers and less frequent self-examiners, with excessive self-examiners re porting significantly higher general anxiety. Breast cancer worries differe ntiated between all three groups in a linear fashion, with increasing cance r worries associated with higher levels of BSE. Conclusions: In some at-ris k women, high cancer anxiety may lead to high general anxiety and precipita te hypervigilant breast self-examination rather than avoidance. These findi ngs are discussed in relation to psychoeducational interventions and geneti c counseling services for women with a family history of breast cancer.