Freelance Writing Jobs | Today's Articles | Sign In

Waiting for Breast Biopsy Results is Stressful

Salivary Cortisol Levels Reflect Anxiety Level of Patients

Mar 1, 2009 Benson Yeung

Researchers attempt to quantify and reduce the stress patients undergoing breast biopsy are subjected to, in order to optimize the outcome of their treatment.

We have always suspected and predicted that the process of waiting for the breast mass biopsy result before it comes out would be extremely stressful. Now we have proof. And the proof comes in the form of a scientific study targeted at quantifying the patients’ level of anxiety.

Salivary Cortisol Assayed

Salivary cortisol (a hormone secreted by the adrenal glands and circulates in blood and body fluids) determination is a well-established biomarker of stress. Dr Elvira Lang and colleagues, from Beth Israel Deaconess Medical Center in Boston, Massachusetts, managed to sample four salivary samples each day for five days after large-core breast biopsy from 150 women who had undergone the diagnostic test to confirm or rule out breast cancer. These readings constitute for each patient a diurnal (meaning measurements taken at different time of the day) cortisol slope. The women studied were aged 18 to 86 years. Diurnal cortisol slopes were compared for women who did not have a final diagnosis, patients who learned they had a malignancy, and those who received a diagnosis of benign disease. The average patient was found to have waited 2.4 days before they had the result of the biopsy. The range of duration was between one and six days.

The Results

In all, 126 diurnal profiles were available by day 5, at which point 16 patients had been diagnosed with a malignancy, while 37 had confirmed benign disease and 73 had an uncertain diagnosis. The team of researchers reports that the average cortisol slope for women with an uncertain diagnosis was significantly flatter than that for women diagnosed with benign disease and not significantly different from that of women who learned they had malignant disease. Contrary to our belief, the disclosed test results had a less significant bearing on the patients’ cortisol levels than the time they had spent waiting for it.

Conclusion

The researchers' conclusion was that “not only how but also when biopsy results become available to the patient is important to avoid the dysregulation of cortisol secretion, even if the results are benign.” These findings should logically call for more speedy disclosure of the results of the diagnostic procedure to the patients in an attempt to reduce the patients anxiety levels. (Other scientific studies have previously repeatedly shown that the patients with high anxiety levels tend to exhinbit lower immunologic response to cancer and the trauma of surgery, as well as delayed post-operative wound healing. Dr Lang and co-workers reported their findings in volume 250: pages 631-637 of the Radiology Journal published in February 2009.

The copyright of the article Waiting for Breast Biopsy Results is Stressful in Women’s Health is owned by Benson Yeung. Permission to republish Waiting for Breast Biopsy Results is Stressful in print or online must be granted by the author in writing.

large core needle breast biopsy