The biological correlates of psychological responses to breast cancer

A prospective, multidisciplinary, 5 year study of 69 consecutive women with early breast cancer was conducted. Patients' psychological responses to the diagnosis were assessed 3 months post- operatively and correlated with various histological, mammographic, hormonal and immunological investigations performed pre-operatively and at 3 months post-operatively. There was no statistically significant association between the type of psychological response and any of the biological measures studied pre-operatively. There is, therefore, no evidence that biological factors have biased the composition of the groups and accounted for observed differences in outcome. Serum levels of IgM, performed 3 months post-operatively, however, were significantly higher in patients who showed denial compared to those who responded with fighting spirit ( p < 0.02) or stoic acceptance ( p < 0.02). Also patients who showed fighting spirit had significantly lower serum levels of IgG than those who showed stoic acceptance ( p < 0.025). The mechanisms by which such immunoglobulin changes could influence survival in cancer remain hypothetical. A greater understanding of the neuroendocrine control of the immune system and much more sophisticated measurements will be needed to elucidate such mechanisms.