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The effect of psychosocial factors on breast cancer outcome: a systematic review

Matthew E Falagas123*, Effie A Zarkadoulia1, Eleni N Ioannidou1, George Peppas14, Christos Christodoulou15 and Petros I Rafailidis13

Author Affiliations

1 Alfa Institute of Biomedical Sciences (AIBS), Athens, Greece

2 Department of Medicine, Tufts University School of Medicine, Boston, Massachusetts, USA

3 Department of Medicine, Henry Dunant Hospital, Athens, Greece

4 Department of Surgery, Henry Dunant Hospital, Athens, Greece

5 Department of Medical Oncology, Henry Dunant Hospital, Athens, Greece

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Breast Cancer Research 2007, 9:R44  doi:10.1186/bcr1744

Published: 17 July 2007



We sought to review the available evidence regarding the effect of psychosocial factors on the survival of breast cancer patients.


We systematically searched the PubMed and PsycINFO databases to identify relevant studies.


We identified 31 studies examining the association of various psychosocial parameters with overall breast cancer survival/disease free survival and 6 studies examining whether psychological intervention influences the disease outcome. Of the 31 studies summarized in this overview, 25 (80.6%) showed a statistically significant association between at least one psychosocial variable and disease outcome. Parameters associated with better breast cancer prognosis are social support, marriage, and minimizing and denial, while depression and constraint of emotions are associated with decreased breast cancer survival; however, the role of these factors has not been verified in all studies.


Most of the studies show a significant relationship between psychosocial factors and survival, but the actual psychosocial variables related to survival are not consistently measured across studies and the findings for many of the psychosocial variables with survival/recurrence are not consistent across studies. Thus, more research is warranted regarding the role of social support, marriage, minimizing and denial, depression and constraint of emotions on breast cancer survival.