breast cancer patients. All were less than 70 years old with

Stage I and II disease and all received simple mastectomy.

Twenty-five randomly selected patients also received post-

operative radiation therapy. Rating scales used in the

psychological assessment included one developed by the

authors for social adjustment, the Hamilton Rating Scale, the

Caine and Foulds Hostility Questionnaire, the Eysenck

Personality Inventory, and the Mill Hill Vocabulary Scale.

Variables evaluated included initial reactions, delay,

characteristic response to stressful events, ability to

express feelings, and occurrence of depressive illness or

loss five years prior to the diagnosis. In follow-up visits,

social adjustments, depression, and psychologic responses to

the diagnosis were re-evaluated. Based on the findings of a

pilot survey the responses to the diagnosis were grouped into

four categories: denial, fighting spirit, stoic acceptance,

and feelings of helplessness/hopelessness.

 At the end of the five year follow-up period, 33 women

were alive with no evidence of disease, 16 were alive with

metastatic disease, and 18 had died of the cancer. The

authors reported no significant associations ( p) .05)

between five-year outcome and the following variables: age,

social class, reaction on discovery of cancer, delay,

habitual reaction to stress, expression of anger, depression,

hostility scores, or previous loss. There was a tendency for

the unmarried or those with poor marital relationships to