New study: Women with early stage breast cancer worry about recurrence

A new study has found that certain types of women with early stage breast cancer are vulnerable to excessive worrying about cancer recurrence. Published early online in CANCER, a peer-reviewed journal of the American Cancer Society, the study also indicates that worrying about cancer recurrence can compromise patients' medical care and quality of life.

Thanks to recent medical advances, most women who are diagnosed with early stage breast cancer have a low risk for cancer recurrence. Despite an optimistic future, many of these women report that they worry that their cancer will come back. While some worry about cancer recurrence is understandable, for some women these worries can be so strong that they have an impact on what treatments women choose, how often they seek care, and their quality of life as cancer survivors.

Nancy Janz, PhD, of the University of Michigan School of Public Health in Ann Arbor led a study that investigated whether worry about recurrence was related to race and ethnicity, acculturation (the process by which members of one cultural group adopt the beliefs and behaviors of another group), clinical and treatment factors, and how women viewed their experience in the health care system while being treated for breast cancer. The researchers studied 2,290 women with non-metastatic breast cancer who were diagnosed from June 2005 to February 2007 and reported to Detroit or Los Angeles cancer registries. A patient's level of worry was determined by assessing her concern about cancer returning to the same breast, the other breast, and spreading to other parts of the body.

Dr. Janz and her team found that women who had greater ease in understanding clinical information that was presented to them, who experienced fewer symptoms, and who received more coordinated care reported less worry about recurrence. Less acculturated Latina breast cancer patients were particularly vulnerable to high levels of worry, while African American patients had significantly less worry than other races. Other factors that were associated with more worry were being younger, being employed, experiencing more pain and fatigue, and undergoing radiation treatment.

"How much women worry about recurrence is often not aligned with their actual risk for cancer recurrence," said Dr. Janz. "We need to better understand the factors that increase the likelihood that women will worry and develop strategies and appropriate referrals to help women with excessive worry," she added. Dr. Janz noted that programs to assist women must be culturally sensitive and tailored to patients' differences in communication style, social support, and coping strategies. She also stressed the importance of appropriately presenting risk information to women with breast cancer so that they can understand their risk and effectively participate in treatment decisions.