Summary

the onset and course of cancer has been active since the 1950s. Recently we reported associations between psychological factors and survival in patients with metastatic melanoma. We now report a replication of this study in a sample of women with metastatic breast cancer. Patients and methods: Ninety-nine patients with metastatic breast cancer completed questionnaires measuring cognitive appraisal of threat, coping, psychological adjustment, per-ceived aim of treatment, social support and quality of life, approximately four months after diagnosis. Survival was measured from date of study entry to date of death or censored at the date of last follow-up for surviving patients. Results: In a multivariate analysis, four factors independ-ently predicted outcome. Patients with metastases in the liver, lung or pleura survived for a shorter duration (P < 0.001); older patients (P < 0.001) and those with a better appetite (P < 0.05) also lived for a shorter time. Patients who mini-mised the impact of cancer survived longer (a median of 29.1 vs. 23.9 months after study entry, P < 0.01). Conclusions: Minimisation was also significantly associ-ated with outcome in patients with metastatic melanoma who participated in an identically designed study, reported else-where. This suggests that minimisation may have a general impact on cancer progression and deserves closer scrutiny in other cancers. Key words: breast cancer, prognostic factors, psychosocial factor