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Aim: Emotionally-restricted and 'poorunderstanding'communication between a patient and their physician may be associated with difficulties in diagnosis and with poor treatment results in clinical practice. To our knowledge, the associations between distance and reserve in patient-physician communication and the risk of breast cancer (BC) are rarely considered together in a prospective study. Patients and Methods: In an extension of the Kuopio Breast Cancer Study, 115 women with breast symptoms were evaluated for emotional distance and reservation in patient-physician communication before any diagnostic procedures were carried out. Results: Clinical examination and biopsy showed BC in 34 patients, benign breast disease (BBD) in 53 patients, while 28 individuals were shown to be healthy (HSS). There was a trend for the BC group to report more emotional distance in patient-physician communication (30/34, 89.0%; grade I to IV emotional distance) than the patients in the HSS and BBD groups (78.6% and 75.5%, grade I to IV emotional distance, respectively). However, the mean of the distance score for HSS, BBD and BC groups differed only slightly in grade II and grade III. The BC group had a higher ERS emotional reservation score in contact (25/34, 73.5%; grade I to IV reserve) than the patients in the HSS and BBD groups (57.1% and 62.1%, grade I to IV reserve, respectively). However, the mean of the reserve score for HSS, BBD and BC groups differed only slightly in grade II, grade III and grade IV. Conclusion: The results of this study showed that patients with BC could be at risk for emotional distance and reserve in patient-physician communication and this should be taken into account in the relationship between the patient and their physician and may have clinical relevance in day-to-day clinical work.


Eskelinen M.,Kuopio University Hospital | Ollonen P.,State Office in Eastern Finland
Anticancer Research | Year: 2011

Background: A hopeful attitude is important for psychological well being, and hopelessness is associated with various chronic illnesses, including cancer. To the Authors' knowledge, the associations between hopelessness and the risk of breast cancer (BC) are rarely considered together in a prospective study. Materials and Methods: In an extension of the Kuopio Breast Cancer Study, 115 women with breast symptoms were evaluated for hopelessness before any diagnostic procedures were carried out. Results: The clinical examination and biopsy showed BC in 34 patients, benign breast disease (BBD) in 53 patients, while 28 individuals were shown to be healthy study subjects (HSS). There was a trend for the BBD and BC group to report clearer hopelessness (18.9% and 20.6%, grade III hopelessness, respectively) than the patients in the HSS group (10.7%, grade III hopelessness). However, the mean sum of the hopelessness score for HSS, BBD and BC groups differed only slightly in other grades. There was a trend for the HSS, BBD and BC groups to 'understage' hopelessness. In the HSS group, no study subjects who reported grade III/IV hopelessness by the self-rating method (SRM) vs. 4/28 (14.3%) subjects of the HSS group reported grade III/IV hopelessness by the examiners rating method (ERM). In the BBD group 7/53 (13.2%) subjects reported grade III/IV hopelessness by the SRM vs. 12/53 (22.7%) subjects of the BBD group by the ERM. In the BC group, 2/34 (5.9%) subjects reported grade III/IV hopelessness by SRM vs. 8/34 (23.5%) subjects of the BC group by the ERM. Conclusion: The results of this study show that patients with BC and BBD are at risk for hopelessness.


Eskelinen M.,University of Eastern Finland | Paula O.,State Office in Eastern Finland
Anticancer Research | Year: 2011

Background: In 1973, Sifneos introduced the word 'alexithymia' to describe the inability to find appropriate words to describe one's feelings. To the Authors' knowledge, the associations between alexithymia and the risk of breast cancer (BC) are rarely considered together in a prospective study. Patients and Methods: In an extension of the Kuopio Breast Cancer Study 115 women with breast symptoms were semi-structurally interviewed in-depth, as well as being asked to complete standardised questionnaires (Beck, Forsen, MADRS, Spielberger), and all study variables were obtained before any diagnostic procedures were carried out. The investigator estimated the alexithymia of the study participants using a 5-point scale. Results: The clinical examination and biopsy showed BC in 34 patients, benign breast disease (BBD) in 53 patients, and 28 individuals were shown to be healthy (HSS). There was a significance for the women with BC to have more alienation from own body (Function C, p=0.03) (mean Alexithymia score, 2.82) than those of the BBD (mean Alexithymia score, 3.40) and HSS groups (mean Alexithymia score, 3.29). The BC group had significantly more alienation from own experience (Function D, p=0.01) (mean Alexithymia score, 2.82) than the patients in the BBD group (mean Alexithymia score, 3.51) and in the HSS group (mean Alexithymia score, 3.36). The BC group also had more alienation from own feelings (Function E, p=0.05) and more deficit in self-experience (Function F, p=0.05) than the patients in the BBD group and the patients in the HSS group. Conclusion: The results of this study show that the patients with BC tended to have an increased risk for alexithymia.


Eskelinen M.,University of Eastern Finland | Ollonen P.,State Office in Eastern Finland
In Vivo | Year: 2010

Background: To the Authors' knowledge, the associations between the life stress and losses and deficit in adulthood and the risk of breast cancer (BC) are rarely considered together in a prospective study. Patients and Methods: In an extension of the Kuopio Breast Cancer Study, 115 women with breast symptoms were semi-structurally interviewed in-depth, as well as asked to complete standardised questionnaires, and all study variables were obtained before any diagnostic procedures were carried out. The Montgomery-Åsberg depression rating scale (MADRS) was used to evaluate the depression of the study participants. Results: The clinical examination and biopsy showed BC in 34 patients, benign breast disease (BBD) in 53 patients, and 28 individuals were shown to be healthy (HSS). The BC group had significantly higher mean score for the loss of social status in adulthood than did the BBD and HSS groups (p<0.05). In addition, the women in the BC group had significantly higher mean score for stress in adulthood in the previous 6-10 years (p<0.01), in the previous 2-6 years (p<0.05) and for stress in adulthood in the previous two years (p<0.05) than the women in the BBD and HSS groups. The BC group also had significantly more severe losses in adulthood than the BBD and HSS groups (p<0.01). The results indicated that breast cancer patients tended to have more life stress and losses in adulthood than did those in the BBD and HSS groups. Conclusion: The results of this study support a weak association between life stress and losses in adulthood and breast cancer risk and it might be that stress and losses impacts indirectly on breast cancer risk, affecting behaviour, or directly on the hypothalamic-pituitary-adrenal axis and autonomic nervous system functioning.


Eskelinen M.,University of Eastern Finland | Ollonen P.,State Office in Eastern Finland
Anticancer Research | Year: 2011

Background: In 1989, Forsen introduced an inventory for psychological identification of breast cancer (BC) patients before biopsy. The associations between the Forsen inventory (FI) and the risk of BC are rarely considered together in a prospective study. Patients and Methods: In an extension of the Kuopio Breast Cancer Study, 115 women with breast symptoms were semi-structurally interviewed in-depth and asked to complete standardised questionnaires (Beck, Forsen and Spielberger) and all study variables were obtained before any diagnostic procedures were carried out. The Montgomery-Åsberg depression rating scale (MADRS) was used to evaluate the depression of the study participants. Results: The clinical examination and biopsy showed BC in 34 patients, benign breast disease (BBD) in 53 patients and 28 individuals were shown to be healthy (HSS). The BC group had more severe anxiety during a two-year prodromal period (4/34 patients, 11.8%) than the BBD (3/53 patients, 5.7%) and HSS groups (1/28 patients, 3.6%). The mean sum of the scores of the FI variables during a six-year prodromal period were significantly lower in the BC group (9.8) than in the BBD (11.8) and HSS groups (12.5). In addition, the women in the BC group tended to use more psychiatric medication during a six-year prodromal period (7/34 patients, 20.6%) than the patients in the BBD (7/53, 13.2%) and HSS groups (3/28, 10.7%). Conclusion: The results of this study support a very weak association between the FI and BC risk. However, the number of cases with psychiatric medications was insufficient to support statistically a specific link between psychiatric medications and increased BC risk.

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