Journal article
Large-Core Breast Biopsy: Abnormal Salivary Cortisol Profiles Associated with Uncertainty of Diagnosis
Radiology, Vol.250(3), pp.631-637
2009
DOI: 10.1148/radiol.2503081087
PMID: 19244038
Abstract
Purpose: To determine whether uncertainty of the diagnosis after large-core breast biopsy (LCBB) adversely affects biochemical stress levels.
Materials and methods: This study was institutional review board approved and HIPAA compliant, and all patients gave written informed consent. One hundred fifty women aged 18-86 years collected four salivary cortisol samples per day for 5 days after LCBB. t Tests were used to compare diurnal cortisol slopes among three groups: patients who did not have a final diagnosis (uncertain group), patients who knew they had cancer (known malignant group), and patients who knew they had benign disease (known benign group).
Results: Women learned their diagnosis on days 1-6 (mean, day 2.4) after LCBB. Analysis was truncated at day 5, when the data from a sufficient number of patients from each group were available for meaningful analysis: 16 patients from the known malignant group, 37 from the known benign group, and 73 from the uncertain group, which totaled 126 patients. The mean cortisol slope for the women with an uncertain diagnosis (-0.092 ln [microg/dL]/hr; 95% confidence interval [CI]: -0.113 ln [microg/dL]/hr, -0.072 ln [microg/dL]/hr) was significantly flatter (less desirable) than that for the women who learned that they had benign disease (-0.154 ln [microg/dL]/hr; 95% CI: -0.197 ln [microg/dL]/hr, -0.111 ln [microg/dL]/hr; P = .014) but not significantly different from that for the women who learned that they had malignant disease (-0.110 ln [microg/dL]/hr; 95% CI: -0.147 ln [microg/dL]/hr, -0.073 ln [microg/dL]/hr; P = .421).
Conclusion: Uncertainty about the final diagnosis after LCBB is associated with substantial biochemical distress, which may have adverse effects on immune defense and wound healing. Results indicate the need for more rapid communication of biopsy results.
Details
- Title: Subtitle
- Large-Core Breast Biopsy: Abnormal Salivary Cortisol Profiles Associated with Uncertainty of Diagnosis
- Creators
- Elvira V LANG - Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Ave, Boston, MA 02115, United StatesKevin S BERBAUM - Department of Radiology, University of Iowa, Iowa City, Iowa, United StatesSusan K LUTGENDORF - Department of Psychology, University of Iowa, Iowa City, Iowa, United States
- Resource Type
- Journal article
- Publication Details
- Radiology, Vol.250(3), pp.631-637
- DOI
- 10.1148/radiol.2503081087
- PMID
- 19244038
- NLM abbreviation
- Radiology
- ISSN
- 0033-8419
- eISSN
- 1527-1315
- Publisher
- Radiological Society of North America; Oak Brook, IL
- Language
- English
- Date published
- 2009
- Academic Unit
- Radiology; Psychological and Brain Sciences; Iowa Neuroscience Institute; Obstetrics and Gynecology; Urology
- Record Identifier
- 9984065773802771
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