Predictive factors for psychological distress related to diagnosis of breast cancer

Tsuguo Iwatani, Ayako Matsuda, Hidetaka Kawabata, Daishu Miura, Eisuke Matsushima

Research output: Contribution to journalArticlepeer-review

31 Citations (Scopus)


Objective The aims of the present study were as follows: (i) to clarify the proportion of women who experience psychological distress during breast cancer diagnosis and (ii) to identify the predictors of psychological distress related to the diagnostic process. Methods This was a longitudinal prospective study of women who required further breast examination. Questionnaires were administered at pre-medical consultations (Time 1), after describing radiological examination (Time 2), and after explaining pathological findings (Time 3). All participants completed Hospital Anxiety and Depression Scale (HADS), Functional Assessment of Cancer Therapy - Breast, and Functional Assessment of Chronic Illness Therapy - Spiritual subscale at Time 1 to identify predictors. Participants also completed HADS at Times 2 and 3 to identify the presence or absence of psychological distress. Results Of the 222 eligible patients, at Time 2, 31 (22.6%) participants with no clinical abnormalities and 39 (45.9%) participants with abnormal findings had HADS scores of ≥11 points (χ2 test, 13.14; p < 0.001). At Time 3, 14 (28.0%) participants with benign breast changes and 24 (68.6%) participants with breast cancer had scores of ≥11 (χ2 test, 13.71; p < 0.001). Higher HADS scores at Time 1 were associated with the presence of psychological distress at all stages of breast cancer diagnosis. Advanced tumor stage was a predictor of psychological distress for participants with breast cancer (odds ratios = 3.314, 95% confidence interval = 1.033-9.509; p = 0.044). Conclusion These results suggest that intensive psychological intervention is necessary for breast cancer patients with large tumors, as well as for women with suspected breast cancer with high HADS scores at pre-consultation.

Original languageEnglish
Pages (from-to)523-529
Number of pages7
Issue number3
Publication statusPublished - Mar 2013
Externally publishedYes


  • breast cancer
  • cancer
  • diagnostic process
  • oncology
  • predictive factor
  • psychological distress

ASJC Scopus subject areas

  • Experimental and Cognitive Psychology
  • Oncology
  • Psychiatry and Mental health


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