The new finding that women with a history of breast cancer experience acute stress-related symptoms with follow-up mammography suggests that the effects of stress related to cancer survival may be greater than previously thought, according to an article in the January/February issue of Psychosomatic Medicine.

“Women with a previous cancer diagnosis reported two to four times as many acute stress symptoms as women with no previous cancer,” says Maria Gurevich, PhD, lead author of the study. Gurevich added that symptoms may be associated with any aspect of mammography, developing before screening, at the time of the test itself, while awaiting results, or after hearing the outcome.

In the current work, Canadian researchers assessed 135 women undergoing mammography at a single large cancer center; 66 women had survived an earlier breast cancer, whereas the other 69 women had never had the disease. The women answered questions about stress levels, trauma history, psychiatric history, social support and physician support. The mammograms done at the time of psychiatric evaluation revealed that all 135 women were free of cancer.

Cancer survivors had already lived for an average of 6.5 years after their first experience with breast cancer, and so roughly two thirds of the women could expect a favorable outcome. Nevertheless, these cancer survivors scored even higher on tests of acute stress than women who were newly diagnosed with breast cancer, Gurevich said, comparing her results with those from an earlier study.

It is especially important to recognize and treat the emotional sequelae of cancer because survivors may become unwilling to return for regular follow-up examinations or to undergo standard screening for other cancers.

Some women avoid follow-up mammograms altogether, even though the American Society of Clinical Oncology recommends annual mammograms for survivors of breast cancer. Earlier studies showed that 30 percent of survivors had not received a mammogram in the prior year.