TY - JOUR
T1 - Immunological and psychosocial predictors of disease recurrence in patients with eariy-stage breast cancer
AU - Levy, Sandra M.
AU - Herberman, Ronald B.
AU - Lippman, Marc
AU - D’Angelo, Teresa
AU - Lee, Jerry
N1 - Copyright:
Copyright 2016 Elsevier B.V., All rights reserved.
PY - 1991
Y1 - 1991
N2 - Ninety women with recently diagnosed stage I or stage II breast cancer who had been admitted to the NIH Clinical Center and were participating in a randomized trial were entered onto this behavioral immunology protocol. Patients were immunologically and psychosocially assessed at baseline (approximately 5 days after surgery) and again at 3 and 15 months post surgery. All of the patients were followed up for a minimum of 5 years, and 60% of the patients were followed for 7 years or longer. Twenty-nine women in the study group reported disease recurrences over the entire follow-up period. Causal path modeling statistical techniques showed that natural killer (NK) cell activity was a strong predictor of disease outcome when the outcome variable was defined as recurrence v nonrecurrence of disease (χ2 = 6.9, p < .001). Higher NK cell activity at follow-up predicted disease-free survival over the follow-up period. When the disease outcome variable was operationally defined as time to recurrent disease, the psychosocial factors were more strongly predictive of the rate of disease progression for those who had a recurrence (χ2 = -4.1, p < .01), but NK cell activity was seemingly less relevant in this latter case. Overall, these findings suggest that including mood and potentially relevant immunological variables, along with important biological prognostic variables, in multivariate and prospective models such as those examined in this study, potentially contributes more to the explanation of greater outcome variance of early-stage breast cancer than has been believed in the past.
AB - Ninety women with recently diagnosed stage I or stage II breast cancer who had been admitted to the NIH Clinical Center and were participating in a randomized trial were entered onto this behavioral immunology protocol. Patients were immunologically and psychosocially assessed at baseline (approximately 5 days after surgery) and again at 3 and 15 months post surgery. All of the patients were followed up for a minimum of 5 years, and 60% of the patients were followed for 7 years or longer. Twenty-nine women in the study group reported disease recurrences over the entire follow-up period. Causal path modeling statistical techniques showed that natural killer (NK) cell activity was a strong predictor of disease outcome when the outcome variable was defined as recurrence v nonrecurrence of disease (χ2 = 6.9, p < .001). Higher NK cell activity at follow-up predicted disease-free survival over the follow-up period. When the disease outcome variable was operationally defined as time to recurrent disease, the psychosocial factors were more strongly predictive of the rate of disease progression for those who had a recurrence (χ2 = -4.1, p < .01), but NK cell activity was seemingly less relevant in this latter case. Overall, these findings suggest that including mood and potentially relevant immunological variables, along with important biological prognostic variables, in multivariate and prospective models such as those examined in this study, potentially contributes more to the explanation of greater outcome variance of early-stage breast cancer than has been believed in the past.
KW - Breast cancer
KW - Mood
KW - Natural killer cells
KW - Social support
UR - http://www.scopus.com/inward/record.url?scp=0025740155&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0025740155&partnerID=8YFLogxK
U2 - 10.1080/08964289.1991.9935161
DO - 10.1080/08964289.1991.9935161
M3 - Article
C2 - 1878611
AN - SCOPUS:0025740155
VL - 17
SP - 67
EP - 75
JO - Behavioral Medicine
JF - Behavioral Medicine
SN - 0896-4289
IS - 2
ER -