Skip to main content

Psychological Adjustment in Breast Cancer Survivors

  • Chapter
Improving Outcomes for Breast Cancer Survivors

Part of the book series: Advances in Experimental Medicine and Biology ((BCRF,volume 862))

Abstract

Women living with a diagnosis of breast cancer constitute more than 20 % of the cancer survivor population in the United States. Research on trajectories of psychological adjustment in women recently diagnosed with breast suggests that the largest proportion of women evidences relatively low psychological distress either from the point of diagnosis or after a period of recovery. Substantial heterogeneity exists, however, and some women are at risk for lingering depression, anxiety, fear of cancer recurrence and other long-term psychological effects. Most women diagnosed with breast cancer also report a number of benefits that arise from their experience of cancer. Longitudinal studies have illuminated risk and protective factors for psychological adjustment in breast cancer survivors, which we describe in this chapter. Effective psychosocial interventions, as evidenced in randomized controlled trials, also are available for bolstering breast cancer-related adjustment. We offer directions for research to deepen the understanding of biological, psychological, and social contributors to positive adjustment in the context of breast cancer, as well as suggestions for the development of optimally efficient evidence-based psychosocial interventions for women living with the disease.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • American Cancer Society (2014) Cancer treatment and survivorship facts and figures 2014–2015. American Cancer Society, Atlanta. Andersen BL, Anderson

    Google Scholar 

  • Andersen BL, DeRubeis RJ, Berman BS, Gruman J, Champion VL, Massie MJ, Holland JC, Partridge AH, Bak K, Somerfield MR, Rowland JH (2014) Screening, assessment and care of anxiety and depressive symptoms in adults with cancer: an American society of clinical oncology guideline adaptation. J Clin Oncol 32:1605–1619

    Article  PubMed Central  PubMed  Google Scholar 

  • Avis NE, Levine B, Naughton MJ, Case LD, Naftalis E, Van Zee KJ (2013) Age-related longitudinal changes in depressive symptoms following breast cancer diagnosis and treatment. Breast Cancer Res Treat 139:199–206

    Article  PubMed  Google Scholar 

  • Basch E, Abernethy AP, Mullins CD, Reeve BB, Smith ML, Coons SJ, Sloan J, Wenzel K, Chauhan C, Eppard W, Frank ES, Lipscomb J, Raymond SA, Spencer M, Tunis S (2012) Recommendations for incorporating patient-reported outcomes into clinical comparative effectiveness research in adult oncology. J Clin Oncol 30:4249–4255

    Article  PubMed  Google Scholar 

  • Bardwell WA, Natarajan L, Dimsdale JE, Rock CL, Mortimer JE, Hollenbach K, Pierce JP (2006) Objective cancer-related variables are not associated with depressive symptoms in women treated for early-stage breast cancer. J Clin Oncol 24:2420–2427

    Google Scholar 

  • Bower JE, Meyerowitz BE, Desmond KA, Bernaards CA, Rowland JH, Ganz PA (2005) Perceptions of positive meaning and vulnerability following breast cancer: predictors and outcomes among long-term breast cancer survivors. Ann Behav Med 29:236–245

    Article  PubMed  Google Scholar 

  • Bower JE, Ganz PA, Crosswell AD, Crespi CM, Stanton AL, Winston D, Cole SW (2014) Effects of mindfulness meditation on stress and inflammation in breast cancer survivors: a randomized controlled trial. Paper presented at the annual meeting of the American psychosomatic society, San Francisco, CA, March 2014

    Google Scholar 

  • Carver CS, Antoni MH (2004) Finding benefit in breast cancer during the year after diagnosis predicts better adjustment 5 to 8 years after diagnosis. Health Psychol 23:595–598

    Article  PubMed  Google Scholar 

  • Christie KM, Meyerowitz BE, Maly RC (2010) Depression and sexual adjustment following breast cancer in low-income Hispanic and non-Hispanic white women. Psycho-Oncology 19:1069–1077

    Article  PubMed Central  PubMed  Google Scholar 

  • Cramer H, Lange S, Klose P, Paul A, Dobos G (2012) Yoga for breast cancer patients and survivors: a systematic review and meta-analysis. BMC Cancer 18:412. doi:10.1186/1471-2407-12-412

    Article  Google Scholar 

  • Crist JV, Grunfeld EA (2013) Factors reported to influence fear of recurrence in cancer patients: a systematic review. Psycho‐Oncology 22: 978–986

    Google Scholar 

  • Cruess DG, Antoni MH, McGregor BA, Kilbourn KM, Boyers AE, Alferi SM, Carver CS, Kumar M (2000) Cognitive-behavioral stress management reduces serum cortisol by enhancing benefit finding among women being treated for early stage breast cancer. Psychosom Medicine, 62:304–308

    Google Scholar 

  • Danhauer SC, Case LD, Tedeschi R, Russell G, Vishnevsky T, Triplett K, Ip EG, Avis NE (2013) Predictors of posttraumatic growth in women with breast cancer. Psycho-Oncology 22:2676–2683

    Article  PubMed  Google Scholar 

  • Diaz M, Aldridge-Gerry A, Spiegel D (2014) Posttraumatic growth and diurnal cortisol slope among women with metastatic breast cancer. Psychoneuroendocrinology. 44:83–87

    Google Scholar 

  • Faller H, Schuler M, Richard M, Heckl U, Weis J, Küffner R (2013) Effects of psycho-oncologic interventions on emotional distress and quality of life in adult patients with cancer: systematic review and meta-analysis. J Clin Oncol 31:782–793

    Article  PubMed  Google Scholar 

  • Gil KM, Mishel M, Bleyea M, Germino B, Porter LS, LaNey IC, Stewart J (2004) Triggers of uncertainty about recurrence and long-term treatment side effects in older African American and Caucasian breast cancer survivors. Oncol Nurs Forum 31:633–639

    Article  Google Scholar 

  • Glasgow RE, Vinson C, Chambers D, Khoury MJ, Kaplan RM, Hunter C (2012) National institutes of health approaches to dissemination and implementation science: current and future directions. Am J Public Health 102:1274–1281

    Article  PubMed Central  PubMed  Google Scholar 

  • Helgeson VS, Snyder P, Seltman H (2004) Psychological and physical adjustment to breast cancer over 4 years: identifying distinct trajectories of change. Health Psychol 23:3–15

    Article  PubMed  Google Scholar 

  • Henselmans I, Helgeson VS, Seltman H, de Vries J, Sanderman R, Ranchor AV (2010) Identification and prediction of distress trajectories in the first year after a breast cancer diagnosis. Health Psychol 29:160–168

    Article  PubMed  Google Scholar 

  • Institute of Medicine, Committee on Cancer Survivorship: Improving Care and Quality of Life, Hewitt M, Greenfield S, Stovall E (eds) (2006) From cancer patient to cancer survivor: lost in transition. National Academies Press, Washington, DC

    Google Scholar 

  • Institute of Medicine, Committee on Psychosocial Services to Cancer Patients/Families in a Community Setting, Adler NE, Page AEK (eds) (2008) Cancer care for the whole patient: meeting psychosocial health needs. National Academies Press, Washington, DC

    Google Scholar 

  • Institute of Medicine, Committee on Improving the Quality of Cancer Care: Addressing the Challenges of an Aging Population, Levit LA, Balogh EP, Nass SJ, Ganz PA (eds) (2013) Delivering high quality cancer care: charting a new course for a system in crisis. National Academies Press, Washington, DC

    Google Scholar 

  • Jacobsen PB, Wagner LI (2012) A new quality standard: the integration of psychosocial care into routine cancer care. J Clin Oncol 30:1154–1159

    Google Scholar 

  • Janz NK, Mujahid MS, Hawley ST, Griggs JJ, Hamilton AS, Katz SJ (2008) Racial-ethnic differences in adequacy of information and support for women with breast cancer. Cancer 113:1058–1067

    Article  PubMed Central  PubMed  Google Scholar 

  • Jaremka LM, Andridge RR, Fagundes CP, Alfano CM, Povoski SP, Lipari AM, Kiecolt-Glaser JK (2013) Pain, depression, and fatigue: loneliness as a longitudinal risk factor. Health Psychol 33:948–957

    Google Scholar 

  • Kangas M, Henry JL, Bryant RA (2002) Posttraumatic stress disorder following cancer: a conceptual and empirical review. Clin Psychol Rev 22:499–524

    Article  PubMed  Google Scholar 

  • Koch L, Jansen L, Brenner H, Arndt V (2012) Fear of recurrence and disease progression in long-term (≥5 years) cancer survivors-a systematic review of quantitative studies. Psycho-Oncology 22:1–11

    Google Scholar 

  • Krebber AMH, Buffart LM, Kleijn G, Riepma IC, de Bree R, Leemans CR, Leeuw IMV (2014) Prevalence of depression in cancer patients: a meta-analysis of diagnostic interviews and self-report instruments. Psycho-Oncology 23:121–130

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  • Kroenke CH, Rosner B, Chen WY, Kawachi I, Colditz GA, Holmes MD (2004) Functional impact of breast cancer by age at diagnosis. J Clin Oncol 22:1849–1856

    Article  PubMed  Google Scholar 

  • Lam WW, Bonanno GA, Mancini AD, Ho S, Chan M, Hung WK, Or A, Fielding, R. (2010) Trajectories of psychological distress among Chinese women diagnosed with breast cancer. Psycho‐Oncology 19:1044–1051

    Google Scholar 

  • Lengacher CA, Johnson‐Mallard V, Post‐White J, Moscoso MS, Jacobsen, PB, Klein TW, ... Kip KE (2009) Randomized controlled trial of mindfulness‐based stress reduction (MBSR) for survivors of breast cancer. Psycho‐Oncology 18:1261–1272

    Google Scholar 

  • Mann E, Smith MJ, Hellier J, Balabanovic JA, Hamed H, Grunfeld EA, Hunter MS (2012) Cognitive behavioural treatment for women who have menopausal symptoms after breast cancer treatment (MENOS1): a randomized controlled trial. Lancet Oncol 13:309–318

    Article  PubMed Central  PubMed  Google Scholar 

  • McGregor BA, Antoni MH, Boyers A, Alferi SM, Blomberg BB, Carver CS (2004) Cognitive–behavioral stress management increases benefit finding and immune function among women with early-stage breast cancer. J Psychosom Research 56:1–8

    Google Scholar 

  • Manne S, Ostroff J, Winkel G, Goldstein L, Fox K, Grana G (2004) Posttraumatic growth after breast cancer: patient, partner, and couple perspectives. Psychosom Med 66:442–454

    PubMed  Google Scholar 

  • Michael YL, Kawachi I, Berkman LF, Holmes MD, Colditz GA (2000) The persistent impact of breast carcinoma on functional health status. Cancer 89:2176–2186

    Article  CAS  PubMed  Google Scholar 

  • Mitchell AJ, Chan M, Bhatti H, Halton M, Grassi L, Johansen C, Meader N (2011) Prevalence of depression, anxiety, and adjustment disorder in oncological, haematological, and palliative-care settings: a meta-analysis of 94 interview-based studies. Lancet Oncol 12:160–174

    Article  PubMed  Google Scholar 

  • Mitchell AJ, Ferguson DW, Gill J, Paul J, Symonds P (2013) Depression and anxiety in long-term cancer survivors compared with spouses and healthy controls: a systematic review and meta-analysis. Lancet Oncol 14:721–732

    Article  PubMed  Google Scholar 

  • Mols F, Vingerhoets AJJM, Coebergh JW, van de Poll-Franse LV (2005) Quality of life among long-term breast cancer survivors: a systematic review. Eur J Cancer 14:2613–2619

    Article  Google Scholar 

  • O’Connor M, Christensen S, Jensen AB, 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 J Cancer 104:419–426

    Google Scholar 

  • Phillips KM, McGinty HL, Gonzalez BD, Jim HSL, Small BJ, Minton S, Jacobsen PB (2013) Factors associated with breast cancer worry 3 years after completion of adjuvant treatment. Psycho-Oncology 22:936–939

    Article  PubMed Central  PubMed  Google Scholar 

  • Pigott TA (2003) Anxiety disorders in women. Psychiatr Clin N Am 26:621–672

    Article  Google Scholar 

  • Pratt LA, Brody DJ. Depression in the U.S. household population, 2009–2012. NCHS data brief, no 172. Hyattsville, MD: National Center for Health Statistics. 2014

    Google Scholar 

  • Satin JR, Linden W, Phillips MJ (2009) Depression as a predictor of disease progression and mortality in cancer patients. Cancer 115:5349–5361

    Google Scholar 

  • Schroevers MJ, Helgeson VS, Sanderman R, Ranchor AV (2010) Type of social support matters for prediction of posttraumatic growth among cancer survivors. Psycho-Oncology 19:46–53

    Article  PubMed  Google Scholar 

  • Sears SR, Stanton AL, Danoff-Burg S (2003) The yellow brick road and the emerald city: benefit finding, positive reappraisal coping and posttraumatic growth in women with early-stage breast cancer. Health Psychol 22:487–497

    Article  PubMed  Google Scholar 

  • Speck RM, Courneya KS, Mâsse LC, Duval S, Schmitz KH (2010) An update of controlled physical activity trials in cancer survivors: a systematic review and meta-analysis. J Cancer Surviv 4:87–100

    Article  PubMed  Google Scholar 

  • Stafford L, Judd F, Gibson P, Komiti A, Mann GB, Quinn M (2013) Screening for depression and anxiety in women with breast and gynaecologic cancer: course and prevalence of morbidity over 12 months. Psycho‐Oncology 22:2071–2078

    Google Scholar 

  • Stanton AL, Snider PR (1993) Coping with a breast cancer diagnosis: A prospective study. Health Psychol 12:16–23

    Google Scholar 

  • Stanton AL (2012) What happens now? Psychosocial care for cancer survivors after medical treatment completion. J Clin Oncol 30:1215–1220

    Article  PubMed  Google Scholar 

  • Stanton AL, Danoff-Burg S, Sworowski LA, Collins CA, Branstetter AD, Rodriguez-Hanley A, Austenfeld JL (2002) Randomized, controlled trial of written emotional expression and benefit-finding in breast cancer patients. J Clin Oncol 20:4160–4168

    Article  PubMed  Google Scholar 

  • Stanton AL, Bower JE, Low CA (2006) Posttraumatic growth after cancer. In: Calhoun LG, Tedeschi RG (eds) Handbook of posttraumatic growth: research and practice. Erlbaum, Mahwah, NJ, pp 138–175

    Google Scholar 

  • Stanton AL, Rowland JH, Ganz PA (2015) Life after diagnosis and treatment of cancer in adulthood: contributions from research in psychosocial oncology. Am Psychol 70:159–174

    Google Scholar 

  • Stanton AL, Luecken LJ, MacKinnon DP, Thompson EH (2013) Mechanisms in psychosocial interventions for adults living with cancer: opportunity for integration of theory, research, and practice. J Consulting Clinical Psychol 81:318–335

    Google Scholar 

  • Tatrow K, Montgomery GH (2006) Cognitive behavioral therapy techniques for distress and pain in breast cancer patients: a meta-analysis. J Behavioral Medicine 29:17–27

    Google Scholar 

  • Tedeschi RG, Calhoun LG (1996) The posttraumatic growth inventory: measuring the positive legacy of trauma. J Trauma Stress 9:455–471

    Article  CAS  PubMed  Google Scholar 

  • Thewes B, Brebach R, Dzidowska M, Rhodes P, Sharpe L, Butow P (2013) Current approaches to managing fear of recurrence; a descriptive survey of psychosocial and clinical health professionals. Psycho-Oncology 23:390–396

    Google Scholar 

  • Torres MA, Pace TW, Liu T, Felger JC, Mister D, Doho GH, Kohn JN, Barsevick AM, Long Q, Miller AH (2013) Predictors of depression in breast cancer patients treated with radiation: role of prior chemotherapy and nuclear factor kappa B. Cancer 119:1951–1959

    Article  PubMed Central  PubMed  Google Scholar 

  • Vallance JKH, Courneya KS, Plotnikoff RC, Yasui Y, Mackey JR (2007) Randomized controlled trial of the effects of print materials and step pedometers on physical activity and quality of life in breast cancer survivors. J Clin Oncol 25:2352–2359

    Article  PubMed  Google Scholar 

  • Vin-Raviv N, Hillyer GC, Hershman DL, Galea S, Leoce N, Bovbjerg DH, Neugut AI (2013) Racial disparities in posttraumatic stress after diagnosis of localized breast cancer: the BQUAL study. J Natl Cancer Inst 105:563–572

    Article  PubMed Central  PubMed  Google Scholar 

  • Vodermaier A, Linden C, Siu C (2009) Screening for emotional distress in cancer patients: a systematic review of assessment instruments. J Natl Cancer Inst 101:1464–1488

    Article  PubMed Central  PubMed  Google Scholar 

  • Yanez B, Thompson EH, Stanton AL (2011) Quality of life among Latina breast cancer patients: a systematic review of the literature. J Cancer Surviv 5:191–207

    Article  PubMed Central  PubMed  Google Scholar 

  • Zainal NZ, Booth S, Huppert FA (2013) The efficacy of mindfulness-based stress reduction on mental health of breast cancer patients: a meta-analysis. Psycho-Oncology 22:1457–1465

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Annette L. Stanton .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2015 Breast Cancer Research Foundation

About this chapter

Cite this chapter

Stanton, A.L., Bower, J.E. (2015). Psychological Adjustment in Breast Cancer Survivors. In: Ganz, P. (eds) Improving Outcomes for Breast Cancer Survivors. Advances in Experimental Medicine and Biology(), vol 862. Springer, Cham. https://doi.org/10.1007/978-3-319-16366-6_15

Download citation

Publish with us

Policies and ethics