Psychological morbidity in women with screen detected and symptomatic breast cancer

The introduction of the National Breast Screening Programme created concern about a possible increase in psychological morbidity. This thesis is concerned with identifying the differences in psychological distress between women with screen detected and symptomatic breast cancer.The sample consisted of 2 groups of women with early breast cancer recruited from a screening unit (n=36) and symptomatic breast clinic (n=32) and a control group of women with no history of breast cancer undergoing general surgical procedures (n=30). The women with breast cancer were interviewed 1 week after diagnosis and asked to complete 3 psychometric measures; the Hospital Anxiety and Depression Scale, The Rotterdam Symptom Checklist and a self esteem scale. These measures were also completed at 3 months and again at 6 months when a further interview was conducted. The control group completed the same psychometric measures but were not interviewed.The results of the study showed significantly more psychological morbidity in the women with symptomatic breast cancer compared to the women with screen detected breast cancer. Positive comments regarding breast screening and the early nature of their breast cancer led to the hypothesis that there was a difference in the way that the screened women perceived their diagnosis. A second study was then undertaken involving interviews with women with screen detected invasive cancer (n=6), screen detected ductal carcinoma in-situ (n=5) and symptomatic breast cancer (n=5). The second study revealed that there was a difference in the way that the 'bad news' was delivered depending on whether the women had screen detected or symptomatic breast cancer. The women with screen detected breast cancer were given more reassurance and the emphasis was placed on the early nature of their disease.