measuring stress in women with newly diagnosed stage i, stage ii, or stage iii breast cancer or ductal carcinoma in situ of the breast

Conditions: Anxiety Disorder; Breast Cancer; Depression; Psychosocial Effects of Cancer and Its Treatment

Summary: rationale: gathering information about how patients respond to stress and measuring stress levels in women with newly diagnosed breast cancer may help doctors provide better methods of treatment and on-going care. purpose: this research study is measuring stress in women with newly diagnosed stage i, stage ii, or stage iii breast cancer or ductal carcinoma in situ of the breast.

objectives: primary * describe the distributions of physiologic, psychosocial, and behavioral response to stress in women with newly diagnosed breast cancer. * describe the patterns of diurnal cortisol rhythms in women newly diagnosed with breast cancer. secondary * determine if diurnal salivary cortisol (mean or pattern) is consistent over two days within two weeks of study entry. * assess the changes in diurnal cortisol rhythm pattern and night-time urinary epinephrine excretion change after an intervening stress event (pre- to post-surgery). * determine if the diurnal cortisol rhythm and the night-time urinary excretion correlate with a variety of self-reported psychosocial factors: optimism (lot-r), state and trait anxiety (stai form y-2), positive and negative affect (panas), depressive symptoms (ces-d), coping (brief cope), and perceived stress (pss-10). * determine if the diurnal cortisol rhythm and the night-time urinary epinephrine excretion correlate with socioeconomic stress and discrimination (functional social support and discrimination \[eod\]). * determine if the diurnal cortisol rhythm and the night-time urinary epinephrine excretion correlate with one lifestyle behavior and dietary fat consumption (block food screener). outline: patients are stratified according to race (caucasian vs african american). patients are instructed to collect saliva and urine samples on 2 separate days, within 2 weeks of study enrollment. saliva samples are collected 6 times a day at baseline, before breast cancer surgery, and 7-10 days after surgery. urine samples are collected after midnight until and including the first morning sample on the saliva-collection days. patients also complete questionnaires (either by telephone interview or in person) within 2 weeks of study enrollment and 7-10 days after breast surgery. stress measures examined include optimism (lot-r), trait-anxiety scale (stai form y-2), functional social support, affect and depression (panas and ces-d), perceived stress (pss-10), economic hardship scales, discrimination (eod), coping mechanisms (brief cope), and dietary fat consumption (block sugar/fat/fruit/vegetable screener).

Eligibility criteria:
inclusion criteria: * diagnosed with stage i-iii invasive breast cancer or ductal carcinoma in situ of the breast within the past 2 weeks * surgery for breast cancer planned * hormone receptor status not specified * female * menopausal status not specified * able to refrain from: * smoking cigarettes for the 24-hour period of saliva-sample collection * brushing teeth or eating for up to one hour prior to saliva collection * more than 1 year since prior therapy for another malignancy * at least 1 month since prior withdrawal from hormone-replacement product * able to refrain from steroid inhalers for greater than 24 hours * no chronic oral steroids

Keywords: anxiety disorder depression psychosocial effects of cancer and its treatment ductal breast carcinoma in situ breast cancer in situ stage i breast cancer stage ii breast cancer stage iiia breast cancer stage iiib breast cancer stage iiic breast cancer