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Psychosocial Impact of Breast Cancer: A Critical Review
Abstract
This article reviews recent literature on the psychosocial impact of breast cancer, with a focus on the adjustment period, treatment, and psychosocial interventions. These studies have shown that as many as one-quarter of women with breast cancer suffer marked psychological morbidity associated with diagnosis and treatment, though for many women psychological distress declines substantially within a year after treatment. Research regarding treatment options has shown that, for women who can be treated with breast-conserving surgery, less invasive surgery may result in less body image concern and better sexual functioning. Factors which appear to moderate the impact of breast cancer on women's psychological health include coping styles, information preferences, social support, and pre-treatment psychiatric morbidity. Studies of psychosocial interventions suggest positive effects of social support, cognitive therapy, and supportive information. Future research efforts should be directed toward understanding special subgroups of women, and developing and testing behavioral interventions to improve psychosocial adjustment among women at high risk. Approaches which enhance patient–provider communication and patient involvement in care may be most beneficial.
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“The diagnosis and treatment of breast cancer bring psychosocial consequences for many patients (Glanz & Lerman, 1992; Moyer & Salovey, 1996), ranging from mild distress to diagnosable mood and anxiety disorders (Antoni, 2003; Holland, 1998).”
From An online stress management workbook for breast cancer (2014) · cites this paper as Glanz & Lerman, 1992
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Petronis, V. M., Carver, C. S., Antoni, M. H., & Weiss, S. M. (2003) · Psychology and Health · doi:10.1080/0887044021000020941 · Cited by 71
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BackgroundPredictors of Social Support and Psychological Distress in Women with Breast Cancer
Moyer, A. E., & Salovey, P. (1999) · Journal of Health Psychology · doi:10.1177/135910539900400212 · Cited by 71
“A number of professionally and non-professionally led supportive interventions for cancer now exist (Glanz & Lerman, 1992; Willits, 1994) and they appear, in general, to be beneficial (Meyer & Mark, 1995).”
BackgroundPsychological Sequelae and Alopecia Among Women with Cancer
McGarvey, E. L., Baum, L. D., Pinkerton, R., et al. (2001) · Cancer Practice · doi:10.1111/j.1523-5394.2001.96007.pp.x · Cited by 70
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“Currently, it is believed that most women diagnosed with early stage breast cancer return to normal levels of emotional adjustment within about a year after diagnosis (for reviews see Glanz & Lerman, 1992; Moyer & Salovey, 1996).”
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“Breast cancer often undermines women’s quality of life and increases their level of psychological distress [1,2].”
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BackgroundCognitive adaptation theory and breast cancer recurrence: Are there limits?
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“A diagnosis of cancer, for example, has been associated with a negative impact on both physical and mental functioning for many individuals (Glanz and Lerman, 1992; Scott and Eisendrath, 1985).”
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“Generally, this type of illness experience is seen as a negative and highly stressful life event, particularly at the time of diagnosis and during treatment (Glanz & Lerman, 1992).”
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“Understanding cancer diagnosis as traumatic is well-established in the context of breast cancer (Glanz & Lerman, 1992; Mehnert & Koch, 2007), and is beginning to be understood across other forms of cancer as well (Gieseler et al., 2018).”
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“Despite the fact that women today are diagnosed earlier and survive longer than women of the past (Glanz & Lerman, 1992), the fact is that some women will experience a recurrence of breast cancer.”
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“…2017, Vol. 113, No. 6, 858–877 0022-3514/17/$12.00 http://dx.doi.org/10.1037/pspa0000105 858 (Berkman, Vaccarino, & Seeman, 1993), lower incidence of cancer (Glanz & Lerman, 1992), and greater longevity (Holt-Lunstad & Smith, 2012; House, Landis, & Umberson, 1988; Oishi & Schimmack, 2010).”
InfluentialPsychological interventions for women with metastatic breast cancer
Edwards, A., Hulbert-Williams, N., & Neal, R. D. (2008) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd004253.pub3 · Cited by 54
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Suwankhong, D., & Liamputtong, P. (2015) · Journal of Nursing Scholarship · doi:10.1111/jnu.12179 · Cited by 48
“These included friends, neighbors, and fellow patients who provided social support in different ways (Glanz & Lerman, 1992; Salonen et al., 2014).”
BackgroundGarrett, K. M., Okuyama, S., Jones, W. C., Barnes, D., Tran, Z. V., Spencer, L., Lewis, K. D., MARONI, P. D., Chesney, M. A., & Marcus, A. (2013) · Patient Education and Counseling · doi:10.1016/j.pec.2013.04.002 · Cited by 46
“In general, the model points to teaching individuals to evaluate their primary appraisals of stressful situations achieve accurate primary appraisals, evaluate coping resources, and enhancing these resources as necessary by increasing functional and tempering less functional coping efforts [45].”
BackgroundTaylor, K. L., Lamdan, R. M., Siegel, J. E., Shelby, R. A., Hrywna, M., & Moran‐Klimi, K. (2002) · Psycho-Oncology · doi:10.1002/pon.616 · Cited by 46
“Sexual attractiveness concerns following treatment for breast cancer have been addressed among white breast cancer patients (e.g. Glanz and Lerman, 1992; Levy et al., 1992; Maraste et al., 1992; Schain et al., 1994; Schover, 1991; Schover et al., 1995), but determining methods for addressing this…”
MethodThe Social Context of Coping with Prostate Cancer
Ptacek, J. T., Pierce, G. R., & Ptacek, J. J. (2002) · Journal of Psychosocial Oncology · doi:10.1300/j077v20n01_04 · Cited by 45
“These couples were selected for investigation because the disease and its treatment pose a host of threats and challenges patients and spouses must cope with (Glanz & Lerman, 1992; Ptacek, Ptacek, & Dodge, 1994).”
BackgroundBaider, L., Andritsch, E., Uziely, B., Ever-Hadani, P., Goldzweig, G., HOFMANN, G., & Samonigg, H. (2003) · European Journal of Cancer Care · doi:10.1046/j.1365-2354.2003.00412.x · Cited by 46
Rates and Correlates of DSM-IV Diagnoses in Women Newly Diagnosed with Breast Cancer
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“…distress following diagnosis and surgery (e.g., Andersen, Anderson, & deProsse, 1989; Epping-Jordon et al., 1999) and this distress persists for up to 2 years post surgery for as many as 30% of these patients (e.g., Glanz & Lerman, 1992; Irvine, Brown, Crooks, Roberts, & Browne, 1991).”
BackgroundAltschuler, A., Rosenbaum, E., Gordon, P., Canales, S., & Avins, A. L. (2012) · Supportive Care in Cancer · doi:10.1007/s00520-011-1216-7 · Cited by 42
“People who receive an initial or recurrent diagnosis of cancer frequently experience great psychosocial distress [1–3].”
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“Moreover, studies have indicated that at least 50% of the variance in psychosocial adjustment to breast cancer is accounted for by non-medical intra-individual variables [cf. (Glanz and Lerman, 1992)].”
BackgroundNarrative Therapy to Prevent Illness-Related Stress Disorder
Petersen, S., Bull, C., Propst, O., Martino, S. D., & Detwiler, L. (2005) · Journal of Counseling & Development · doi:10.1002/j.1556-6678.2005.tb00578.x · Cited by 41
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“Given the substantial variability in adjustment to breast cancer [6], identifying the psychosocial factors that disrupt or enhance adaptation is an important challenge.”
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BackgroundPredictors of depressive symptoms among breast cancer patients during the first year post diagnosis
Schlegel, R. J., Manning, M. A., Molix, L. A., Talley, A. E., & Bettencourt, B. A. (2012) · Psychology & Health · doi:10.1080/08870446.2011.559232 · Cited by 38
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“The physical effects that a woman may experience as a result of cancer treatment are accompanied by a number of negative social psychological impacts that change a woman’s life and her specific occupational, domestic, and familial roles (Glanz & Lerman, 1992).”
BackgroundChange in Need for Psychosocial Support for Women with Early Stage Breast Cancer
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“Breast cancer was the most common cancer worldwide in women accounting for more than 25% of the total number of new cases diagnosed in 2012 [2, 3].”
BackgroundPatterns of Coping in Women Completing Treatment for Breast Cancer
Rosberger, Z., Edgar, L., Collet, J., & Fournier, M. A. (2002) · Journal of Psychosocial Oncology · doi:10.1300/j077v20n03_02 · Cited by 29
“Glanz and Lerman (1992) estimated that more than half the variance in psychosocial adjustment to breast cancer may be attributed to coping styles.”
BackgroundUsing Disease-Related and Demographic Variables to Form Cancer-Distress Risk Groups
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“Though numerous studies have shown that, for a small group of patients, adjustment levels remain consistent over time (Glanz and Lerman, 1992), assessment of phase-specific adjustment takes into consideration the medical context as well as simply the duration since the diagnosis.”
BackgroundPhysical Activity and Breast Cancer Survivorship
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BackgroundInfluentialPost Traumatic Stress Disorders in a Global Context
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“One relates to the social environment as promoting well-being and affecting morbidity and mortality [14], while the other relates to the fact that having cancer affects directly and indirectly interpersonal relationships [15].”
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“Emotional stress is felt by at least half of all breast cancer patients,(75) and one fourth of patients will experience clinically significant psychological disorders.(76) Anxiety, stress, and distress related to medical procedures can arise from fear for health, uncertainty about outcome, combined with a profound los…”
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“loss of sexual attractiveness; confusion about etiology; uncertainty about the effects and effectiveness of treatment regimens; and, even if treatment works in the short term, dread ofrecurrence (Glanz & Lerman, 1992; McKenzie & Crouch,”
BackgroundConcepts, theories and psychosocial factors in cancer adaptation.
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Physikalische Medizin und Rehabilitation unter geschlechtsspezifischen Aspekten
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“For example, use of denial and avoidant coping strategies during active chemotherapy or radiation (as opposed to information-seeking and problem-solving skills during treatment planning) may be more helpful in reducing treatment side effects [7].”
BackgroundCounseling Needs of Women With Breast Cancer: What the Women Tell Us
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BackgroundPsychospiritual well-being and symptom distress in women with breast cancer.
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BackgroundMethodPsychosocial concerns of women with breast cancer
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“They may be exacerbated by the distress associated with continued testing and monitoring.(27,28) However, some research has suggested that fear of recurrence may decrease over time(29,30) and that age may be inversely associated with these fears.”
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“…factors, medical (e.g. history of chemotherapy, type of surgery, stage of cancer; (Broeckel, Jacobsen, Horton, Balducci, & Lyman, 1998; Glanz & Lerman, 1992; Moyer & Salovey, 1996)) and demographic factors (e.g. age, race, ethnicity, education, and marital status; (Avis, Crawford, &…”
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“In addition, Glanz and Lerman (1992) found that symptoms persisted for as many as two years after adjuvant therapy was complete.”
BackgroundState Anxiety and Cancer-Specific Anxiety in Survivors of Breast Cancer
Rothrock, N. E., Matthews, A. K., Sellergren, S. A., Fleming, G. F., & List, M. A. (2004) · Journal of Psychosocial Oncology · doi:10.1300/j077v22n04_06 · Cited by 17
“In an earlier review of the literature, Glanz and Lerman (1992) concurred with this model of anxiety in cancer survivors.”
BackgroundWomen’s Experiences of Breast Cancer
Rosenbaum, M., & Roos, G. (2000) · Breast Cancer · doi:10.1007/978-1-137-03779-4_6 · Cited by 16
Translational behavioral research in cancer genetics.
Lerman, C. (1997) · Preventive Medicine · doi:10.1006/pmed.1997.0204 · Cited by 18
Self-citationHoffman, G., Krenn, G., Baider, L., Andritsch, E., Goldzweig, G., Samonigg, H., Ever-Hadani, P., & Uziely, B. (2004) · Supportive Care in Cancer · doi:10.1007/s00520-003-0531-z · Cited by 16
“Glanz and Lerman [17] reviewed the literature and concluded that avoidant coping can be especially beneficial during active treatment.”
BackgroundInfluentialMustian, K. M., Katula, J. A., & Gill, D. L. (2002) · Women & Therapy · doi:10.1300/j015v25n02_08 · Cited by 15
“Fortunately, social and cultural interpretations of the breast cancer phenomenon are evolving (Glanz & Lerman, 1992).”
BackgroundLocating Breast Cancer in the Context of Women's Lives
Vickberg, S. M. J. (2003) · Journal of Psychosocial Oncology · doi:10.1300/j077v21n02_05 · Cited by 14
“However, this distress is reduced substantially in the year following diagnosis, and the majority of women with breast cancer are well adjusted (Glanz & Lerman, 1992; Omne-Ponten & Sjöden, 1994; Schover et al., 1995; Vickberg et al., 2000).”
BackgroundPatient satisfaction after breast cancer surgery
Leser, C., Tan, Y. Y., Singer, C., Zeillinger, R., Fitzal, F., Lehrner, J. P., König, D., Deutschmann, C., & Gschwantler‐Kaulich, D. (2020) · Wiener klinische Wochenschrift · doi:10.1007/s00508-020-01730-w · Cited by 15
Kadmon, I., Wruble, A. C. K. W., Yong-qin, J., et al. (2004) · European Journal of Oncology Nursing · doi:10.1016/s1462-3889(03)00071-1 · Cited by 14
“The psychosocial aspects of the disease have been the subject of much research in the previous decade (Glanz and Lerman, 1992; Carrison and Hamrin, 1994; Fallowfield, 1996).”
BackgroundEvidence for the benefits of lifestyle medicine interventions in breast cancer survivorship
Wright, L. E., & Sudheendra, P. K. (2024) · The Oncologist · doi:10.1093/oncolo/oyae303 · Cited by 13
Distress and quality of life in an ethnically diverse sample awaiting breast cancer surgery
Rebholz, W. N., Cash, E. D., Zimmaro, L. A., Bayley-Veloso, R., Phillips, K. M., Siwik, C. J., Chagpar, A. B., Dhabhar, F. S., Spiegel, D., Bell, B. S., et al. (2016) · Journal of Health Psychology · doi:10.1177/1359105316659916 · Cited by 13
“Distress related to diagnosis worsens with cancer-related physical impairment (Glanz and Lerman, 1992; Portenoy et al., 1994).”
BackgroundPractical support for women with breast cancer
Thorne, S. E., Balneaves, L. G., & Reimer, J. (1999) · Canadian Oncology Nursing Journal · doi:10.5737/1181912x927477 · Cited by 13
Fletcher, K. E., Clemow, L., Peterson, B. A., Lemon, S., Estabrook, B. B., & Zapka, J. G. (2006) · Health Psychology · doi:10.1037/0278-6133.25.3.413 · Cited by 13
Quality-of-Life Measurement in Women with Breast Cancer
McQuellon, R. P., Kimmick, G. G., & Hurt, G. J. (1997) · The Breast Journal · doi:10.1111/j.1524-4741.1997.tb00163.x · Cited by 13
Metadata
- Authors
- Glanz, K., & Lerman, C.
- Affiliations
- Fox Chase Cancer Center (US)
- Corresponding author
- Glanz, Karen
- ORCID
- Glanz, Karen
- Venue
- Annals of Behavioral Medicine
- Publisher
- Oxford University Press (OUP)
- Published
- 1992
- Volume
- 14
- Issue
- 3
- Pages
- 204-212
- ISSN
- 0742-5554 (ISSN-L)
- 0883-6612
- 1532-4796
- OpenAlex
- W2257891381
- Cited by
- 292
- References
- 0
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 4 · 2023: 1 · 2022: 3 · 2021: 2 · 2020: 3 · 2019: 3 · 2018: 2 · 2017: 2 · 2016: 5 · 2015: 5 · 2014: 5 · 2013: 6 · 2012: 10
- FWCI
- 1.12
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Annals of Behavioral Medicine (publishedVersion)
- Topics
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Women's cancer prevention and management
- Social Sciences › Psychology › Clinical Psychology › Family Support in Illness
- Keywords
- breast cancer, psychosocial impact, psychological distress, psychosocial adjustment, breast-conserving surgery, body image, sexual function, coping styles, social support, information preferences, cognitive therapy, patient-provider communication, behavioral interventions
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