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.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
American Cancer Society (2014) Cancer treatment and survivorship facts and figures 2014–2015. American Cancer Society, Atlanta. Andersen BL, Anderson
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
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
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
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
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
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
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
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
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
Crist JV, Grunfeld EA (2013) Factors reported to influence fear of recurrence in cancer patients: a systematic review. Psycho‐Oncology 22: 978–986
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
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
Diaz M, Aldridge-Gerry A, Spiegel D (2014) Posttraumatic growth and diurnal cortisol slope among women with metastatic breast cancer. Psychoneuroendocrinology. 44:83–87
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
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
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
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
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
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
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
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
Jacobsen PB, Wagner LI (2012) A new quality standard: the integration of psychosocial care into routine cancer care. J Clin Oncol 30:1154–1159
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
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
Kangas M, Henry JL, Bryant RA (2002) Posttraumatic stress disorder following cancer: a conceptual and empirical review. Clin Psychol Rev 22:499–524
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
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
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
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
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
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
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
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
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
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
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
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
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
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
Pigott TA (2003) Anxiety disorders in women. Psychiatr Clin N Am 26:621–672
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
Satin JR, Linden W, Phillips MJ (2009) Depression as a predictor of disease progression and mortality in cancer patients. Cancer 115:5349–5361
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
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
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
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
Stanton AL, Snider PR (1993) Coping with a breast cancer diagnosis: A prospective study. Health Psychol 12:16–23
Stanton AL (2012) What happens now? Psychosocial care for cancer survivors after medical treatment completion. J Clin Oncol 30:1215–1220
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
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
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
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
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
Tedeschi RG, Calhoun LG (1996) The posttraumatic growth inventory: measuring the positive legacy of trauma. J Trauma Stress 9:455–471
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
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
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
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
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
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
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
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights 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
DOI: https://doi.org/10.1007/978-3-319-16366-6_15
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-16365-9
Online ISBN: 978-3-319-16366-6
eBook Packages: Biomedical and Life SciencesBiomedical and Life Sciences (R0)