Waiting for breast cancer biopsy results causes distress



The stress of waiting for a breast biopsy result may cause adverse health effects in women, the results of a new study indicate.

“When women express how taxing it is to have to wait for results, the medical establishment may dismiss their feelings as psychological. We were able to show that this state of not knowing the diagnosis goes along with biochemical changes which can have adverse effects on wound healing and the immune system,” explained the study’s lead author, Dr Elvira Lang of Harvard Medical School.

The researchers analysed cortisol samples collected form the saliva of 126 women who had undergone a biopsy. Cortisol is a hormone produced by the adrenal gland and is often referred to as the ‘stress hormone’. The production of cortisol is part of the body’s natural response to stress.

“Cortisol helps us fight acute stress by adjusting blood pressure, blood sugar and immune response in a good way when needed. But when stress becomes chronic, cortisol secretion either goes into continuous overdrive or dries up, leaving the immune system vulnerable and other body functions less well adapted,” Dr Lang explained.

The women participating in the study had undergone breast biopsies and had been told their diagnosis between one and six days after the procedure. Salivary cortisol samples were collected on the day of the biopsy and each of the four days following the procedure.

During the period in which the samples were taken, the women learned whether their biopsy results were benign (non-cancerous), malignant (cancerous) or uncertain. By the fourth day after biopsy, 16 patients had learned they had cancer, 37 patients had benign findings and 73 patients had an uncertain diagnosis, because their results had not been communicated yet or they required further diagnostic procedures.

The study found that the cortisol secretion among the women with uncertain results was significantly different to that of the women with benign results. In fact, it was very similar to the cortisol secretion levels found in the women with malignant results.

The researchers said that they hope that these findings will encourage a faster analysis and communication of biopsy results. Writing in the journal Radiology, they say: “Our study findings led us to conclude 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.”

“Women should ask who will communicate their results to them and how long it will take to receive them. Then they should schedule the biopsy accordingly, taking into account delays over weekends and holidays. It is no longer so easy for healthcare providers to overlook the effects of extended waiting and say ‘Oh, it’s just nerves,'” Dr Lang added.

Details of these findings are published in the journal, Radiology.

This article appeared in the Irish Times