Idealization as a risk factor for breast cancer in patients with breast disease--a prospective case-control study in Kuopio, Finland.

BACKGROUND

Earlier studies have described a cancer prone personality that is believed to predispose an individual to developing cancer. This cancer prone personality has been shown in studies related to stress. To our knowledge, the association between idealization and risk of breast cancer are rarely considered together.

PATIENTS AND METHODS

This study is an extension of the Kuopio Breast Cancer Study. Women with breast symptoms were referred by their physicians to the Kuopio University Hospital (Finland) and were asked to participate in this study. These women (n =115) were interviewed and all study variables were obtained before any diagnostic procedures were carried out, so neither the investigator nor the subjects knew the final diagnosis of breast symptoms at the time of the interview. The research method used was the semistructured in-depth interview method. The investigator used the Montgomery-Asberg Depression Rating Scale (MADRS) to evaluate the depression of the study subjects. All study subjects were also asked to complete standardised questionnaires (Beck Depression Inventory and Spielberger Trait Inventory). The investigator estimated the amount of idealization using a 3-point scale: grade I, no idealization; grade II, mild/moderate idealization; grade III, severe idealization.

RESULTS

The clinical examination and biopsy showed breast cancer (BC) in 34 patients, benign breast disease (BBD) in 53 patients and 28 study subjects were shown to be healthy (HSS). The results indicated that breast cancer patients used more idealization of childhood and motherhood (p = 0.04) than the BBD and HSS groups. Idealization was significantly associated with our increased breast cancer risk (odds ratio = 1.6, confidence interval = 1.1-2.5, p = 0.03).

CONCLUSION

The results of this study support a moderate association between idealization and increased breast cancer risk. However, the biological explanation of the association is unclear and it might be that idealization and the coping and defensive process impact indirectly, by affecting behaviours such as diet or sleep, or directly on neuroimmunological or hormonal systems.