Abstract
Introduction This prospective study reports on the impact of psychological factors on women with
primary breast cancer undergoing neoadjuvant chemotherapy. These women are in a special
situation, where they not only have to deal with the shock of the cancer diagnosis
but also with the fact that the malignant tumor will not be removed immediately but
only after completing chemotherapy. A situation like this is stressful and requires
a personal strength which not every woman may have.
Methods In a prospective study 53 patients were assessed using various psychological and
psycho-oncological questionnaires which aimed to evaluate their psychological stress
and their coping resources. The women were evaluated before starting systemic treatment
(t-1) and again immediately after completing chemotherapy but prior to surgery (t-2).
The patients were also asked about their coping strategies at t-1 and t-2. Using the
Ulm Coping Manual (UCM) the interviews were rated by independent assessors blinded
to the respective patientʼs medical data. Patients were followed up for 3.7–5.5 years
after completing chemotherapy.
Results Patients with poor psychosocial adjustment to the situation were identified prior
to starting treatment (at t-1). The social coping strategies of these women were found
to be inadequate. Their coping behavior was characterized by resignation and they
did not attempt to seek social support. This was found to increase their overall risk
of recurrence or of developing another type of malignancy during the follow-up period.
The study also identified patients who coped significantly better with primary systemic
treatment by strengthening their coping strategies.
Conclusion Careful psychological screening of womenʼs vulnerabilities or strengths immediately
after the diagnosis and prior to any oncological treatment is strongly recommended.
This would help to identify those patients early on who will require additional psycho-oncological
support due to their psychological vulnerability.
Key words
breast cancer - neoadjuvant chemotherapy - coping with cancer
