Negative affectivity, restriction of emotions, and site of metastases predict mortality in recurrent breast cancer

Objective: To assess whether negative affectivity and restriction of emotions predict survival time with recurrent breast cancer. Methods: Thirty-two patients with recurrent breast cancer, diagnosed 6-19 months earlier and stabilized using surgical, medical and/or radiation therapies, were enrolled. Cox regression survival analyses, including initial severity of metastases (RR = 4.3 [1.3-14.3]; p = 0.02), were used to explore the association of psychological variables with survival. Results: Low chronic anxiety in the context of low emotional constraint predicted low mortality (RR 0.07 [0.01-0.52]; p = 0.007). However, patients with low chronic anxiety scores but with high constraint had higher mortality (RR = 3.7 [1.2-11.5; p = 0.02). High chronic anxiety, with or without high constraint, also predicted earlier death, as did high control of feelings. Conclusion: An integrated model of negative affectivity in the context of restriction of emotions appears to strengthen the prediction of survival based on severity of breast cancer metastases. (C) 2000 Elsevier Science Inc. All rights reserved.