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How traumatic is breast cancer? Post-traumatic stress symptoms (PTSS) and risk factors for severe PTSS at 3 and 15 months after surgery in a nationwide cohort of Danish women treated for primary breast cancer.
Br J Cancer. 2011 Feb 01; 104(3):419-26.BJ

Abstract

BACKGROUND

The literature shows considerable between-study variation in the prevalence of post-traumatic stress symptoms (PTSS) among women with breast cancer. Our aim was, therefore, to explore the prevalence of and risk factors for cancer-related PTSS in a nationwide inception cohort of women treated for primary breast cancer.

METHODS

In all, 68% of all Danish women receiving surgery for primary breast cancer between October 2001 and March 2004 completed a questionnaire at 3 months post surgery (n=3343), which included the impact of event scale (IES). In all, 94% of the disease-free women also completed a follow-up questionnaire at 15 months post surgery. Data on pre-cancer demographic, socioeconomic, and psychiatric status were obtained from national registries. The Danish Breast Cancer Cooperative Group and surgical departments provided information on disease variables, treatment, and comorbidity.

RESULTS

At 3 months post surgery, 20.1% had IES total scores suggesting severe PTSS (35), compared with 14.3% at 15 months. In all, 48% with severe PTSS at 3 months also had scores above the cutoff at 15 months. Main predictors of severe PTSS at 15 months were low social status, previous physical and mental illness, axillary lymph node involvement (>3), and reduced physical functioning (PF) at 3 months.

CONCLUSION

The results confirm that receiving a breast cancer diagnosis can be a significant traumatic experience, and that many women experience persistent cancer-related PTSS. Low social status, poor health status, low levels of PF, and disease severity were found to be risk factors for severe PTSS.

Authors+Show Affiliations

Psychooncology Research Unit, Institute of Psychology, Aarhus University, Jens Christian Skousvej 4, Aarhus C 8000, Denmark. maja@psy.au.dkNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

21224851

Citation

O'Connor, M, et al. "How Traumatic Is Breast Cancer? Post-traumatic Stress Symptoms (PTSS) and Risk Factors for Severe PTSS at 3 and 15 Months After Surgery in a Nationwide Cohort of Danish Women Treated for Primary Breast Cancer." British Journal of Cancer, vol. 104, no. 3, 2011, pp. 419-26.
O'Connor M, Christensen S, Jensen AB, et al. How traumatic is breast cancer? Post-traumatic stress symptoms (PTSS) and risk factors for severe PTSS at 3 and 15 months after surgery in a nationwide cohort of Danish women treated for primary breast cancer. Br J Cancer. 2011;104(3):419-26.
O'Connor, M., Christensen, S., Jensen, A. B., Møller, S., & Zachariae, R. (2011). How traumatic is breast cancer? Post-traumatic stress symptoms (PTSS) and risk factors for severe PTSS at 3 and 15 months after surgery in a nationwide cohort of Danish women treated for primary breast cancer. British Journal of Cancer, 104(3), 419-26. https://doi.org/10.1038/sj.bjc.6606073
O'Connor M, et al. How Traumatic Is Breast Cancer? Post-traumatic Stress Symptoms (PTSS) and Risk Factors for Severe PTSS at 3 and 15 Months After Surgery in a Nationwide Cohort of Danish Women Treated for Primary Breast Cancer. Br J Cancer. 2011 Feb 1;104(3):419-26. PubMed PMID: 21224851.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - How traumatic is breast cancer? Post-traumatic stress symptoms (PTSS) and risk factors for severe PTSS at 3 and 15 months after surgery in a nationwide cohort of Danish women treated for primary breast cancer. AU - O'Connor,M, AU - Christensen,S, AU - Jensen,A B, AU - Møller,S, AU - Zachariae,R, Y1 - 2011/01/11/ PY - 2011/1/13/entrez PY - 2011/1/13/pubmed PY - 2011/3/22/medline SP - 419 EP - 26 JF - British journal of cancer JO - Br. J. Cancer VL - 104 IS - 3 N2 - BACKGROUND: The literature shows considerable between-study variation in the prevalence of post-traumatic stress symptoms (PTSS) among women with breast cancer. Our aim was, therefore, to explore the prevalence of and risk factors for cancer-related PTSS in a nationwide inception cohort of women treated for primary breast cancer. METHODS: In all, 68% of all Danish women receiving surgery for primary breast cancer between October 2001 and March 2004 completed a questionnaire at 3 months post surgery (n=3343), which included the impact of event scale (IES). In all, 94% of the disease-free women also completed a follow-up questionnaire at 15 months post surgery. Data on pre-cancer demographic, socioeconomic, and psychiatric status were obtained from national registries. The Danish Breast Cancer Cooperative Group and surgical departments provided information on disease variables, treatment, and comorbidity. RESULTS: At 3 months post surgery, 20.1% had IES total scores suggesting severe PTSS (35), compared with 14.3% at 15 months. In all, 48% with severe PTSS at 3 months also had scores above the cutoff at 15 months. Main predictors of severe PTSS at 15 months were low social status, previous physical and mental illness, axillary lymph node involvement (>3), and reduced physical functioning (PF) at 3 months. CONCLUSION: The results confirm that receiving a breast cancer diagnosis can be a significant traumatic experience, and that many women experience persistent cancer-related PTSS. Low social status, poor health status, low levels of PF, and disease severity were found to be risk factors for severe PTSS. SN - 1532-1827 UR - https://www.unboundmedicine.com/medline/citation/21224851/How_traumatic_is_breast_cancer_Post_traumatic_stress_symptoms__PTSS__and_risk_factors_for_severe_PTSS_at_3_and_15_months_after_surgery_in_a_nationwide_cohort_of_Danish_women_treated_for_primary_breast_cancer_ L2 - http://dx.doi.org/10.1038/sj.bjc.6606073 DB - PRIME DP - Unbound Medicine ER -