Psychosocial risk scale (PRS) for breast cancer in patients with breast disease: a prospective case-control study in Kuopio, Finland.

BACKGROUND

In 1982, Wirsching et al. introduced a psychosocial risk scale (PRS) for psychological identification of breast cancer patients before biopsy. To our knowledge, the associations between PRS and risk of breast cancer are rarely considered together in a prospective study.

PATIENTS AND METHODS

This study is an extension of the Kuopio Breast Cancer Study. Women with breast symptoms were referred by 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 participants 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 participants. All participants were also asked to complete standardized questionnaires (Beck depression inventory and Spielberger trait inventory). The investigator estimated the PRS using a 3-point scale: grade I, low psychosocial risk; grade II, mild/moderate psychosocial risk; grade III, high psychosocial risk for breast cancer.

RESULTS

The clinical examination and biopsy showed breast cancer in 34 patients, benign breast disease in 53 patients, and 28 individuals were shown to be healthy (HSS). The results indicated that breast cancer patients used more idealization of childhood, and motherhood (p=0.04) than did the other groups. PRS was significantly associated with increased breast cancer risk (p=0.05).

CONCLUSION

The results of this study support a moderate association between Wirsching et al.'s PRS score and breast cancer risk. However, the biological explanation for such an association is unclear and the exact effects of psychological factors on the various hormones relevant to development of breast cancer are at present poorly defined.