Epidemiological evidence for a relationship between life events, coping style, and personality factors in the development of breast cancer

• Published in: Journal of psychosomatic research 2000-09, Vol.49 (3), p.169-181
• Main Authors: Butow, Phyllis N, Hiller, Janet E, Price, Melanie A, Thackway, Sarah V, Kricker, Anne, Tennant, Christopher C
• Format: Article
• Language: English
• Subjects: Adaptation, Psychological; Biological and medical sciences; Breast cancer; Breast neoplasms; Breast Neoplasms - epidemiology; Breast Neoplasms - psychology; Coping style; Emotions; Epidemiologic Studies; Female; Fundamental and applied biological sciences. Psychology; Gynecology. Andrology. Obstetrics; Humans; Illness and personality; Illness, stress and coping; Life Change Events; Life events; Mammary gland diseases; Medical sciences; Personality; Personality Inventory; Psychology and medicine; Psychology. Psychoanalysis. Psychiatry; Psychology. Psychophysiology; Psychosocial factors; Risk Factors; Social support; Stress; Stress, Psychological; Tumors
• ISSN: 0022-3999; 1879-1360
• DOI: 10.1016/S0022-3999(00)00156-2

Objective: Review empirical evidence for a relationship between psychosocial factors and breast cancer development. Methods: Standardised quality assessment criteria were utilised to assess the evidence of psychosocial predictors of breast cancer development in the following domains: (a) stressful life events, (b) coping style, (c) social support, and (d) emotional and personality factors. Results: Few well-designed studies report any association between life events and breast cancer, the exception being two small studies using the Life Events and Difficulties Schedule (LEDS) reporting an association between severely threatening events and breast cancer risk. Seven studies show anger repression or alexithymia are predictors, the strongest evidence suggesting younger women are at increased risk. There is no evidence that social support, chronic anxiety, or depression affects breast cancer development. With the exception of rationality/anti-emotionality, personality factors do not predict breast cancer risk. Conclusion: The evidence for a relationship between psychosocial factors and breast cancer is weak. The strongest predictors are emotional repression and severe life events. Future research would benefit from theoretical grounding and greater methodological rigour. Recommendations are given.