Psychosocial predictors of survival: Metastatic breast cancer

Background: Research interest in psychosocial predictors of the onset and c ourse of cancer has been active since the 1950s. Recently we reported assoc iations between psychological factors and survival in patients with metasta tic melanoma. We now report a replication of this study in a sample of wome n with metastatic breast cancer. Patients and methods: Ninety-nine patients with metastatic breast cancer co mpleted questionnaires measuring cognitive appraisal of threat, coping, psy chological adjustment, perceived aim of treatment, social support and quali ty of life, approximately four months after diagnosis. Survival was measure d from date of study entry to date of death or censored at the date of last follow-up for surviving patients. Results: In a multivariate analysis, four factors independently predicted o utcome. Patients with metastases in the liver, lung or pleura survived for a shorter duration (P < 0.001); older patients (P < 0.001) and those with a better appetite (P < 0.05) also lived for a shorter time. Patients who min imised the impact of cancer survived longer (a median of 29.1 vs. 23.9 mont hs after study entry, P < 0.01). Conclusions: Minimisation was also significantly associated with outcome in patients with metastatic melanoma who participated in an identically desig ned study, reported elsewhere. This suggests that minimisation may have a g eneral impact on cancer progression and deserves closer scrutiny in other c ancers.