Gunthard Weber

Psychological identification of breast cancer patients before biopsy.

Fifty-six women admitted consecutively for a breast biopsy were interviewed on the day prior to the operation. Interviewer ratings and blind ratings (audiotapes) allowed a [statistically significant (alpha = 5%)] differentiation of women in whom the biopsy revealed a cancer from those whose tumor was benign. The ratings took into account characteristics assumed to be typical of the women with cancer: (1) being inaccessible or overwhelmed when interviewed; (2) emotional suppression with sudden outbursts; (3) rationalization; (4) little or no anxiety before the operation; (5) demonstration of optimism; (6) superautonomous self-sufficiency; (7) altruistic behaviour; (8) harmonization and avoidance of conflicts. On the basis of the interviews the interviewer and a blind rater predicted the correct diagnosis in 83% and 94% of all cancer patients and in 71% and 68% of all benign cases. This result is also significant (alpha = 5%). The identified psychological syndrome was found in all breast cancer patients but also in a quarter to a third of the patients with benign nodes. We interpret it as a long-standing defensive pattern adopted in the face of extreme emotional stress. A possible etiological significance for the cancerous disease cannot be derived from this study.

Prebioptic Psychological Characteristics of Breast Cancer Patients

63 women were examined the day before breast biopsy using psychological ratings, speech analysis and questionnaire testings. Ratings revealed differences (benign vs. malignant, a = 5%) in 8 of 10 scales, cancer patients being inaccessible, altruistic, suppressing feelings, rationalizing and harmonizing. The biopsys result was predicted in 75% of all cases. Questionnaire testing showed differences in 7 of 16 scales. It proved cancer patients to be more dependent, anxious, aggressive, health-conscious, family-bound and antisexual. A discriminant analysis correctly identified 77% of cancer and 87% of benign patients. Speech analysis (Gottschalk-Gleser) revealed only minor differences: fewer aggressive and more anxious utterances from cancer patients. Conclusions are drawn for the care and treatment of breast cancer patients.