Breast Disease: Etiology, Prevention, and Rehabilitation

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The prevalence of breast disease renders it an important new area of interest for rehabilitation psychologists. At some time in their lives, 9% of American women will develop breast cancer and at least 50% will be diagnosed as having fibrocystic breast disease. Although the etiological factors responsible for breast pathology have not been determined, research has identified many variables that are related to the development of benign and malignant breast disease. A theoretical model is presented that describes behavioral and constitutional factors associated with fibrocystic disease and breast cancer. The model identifies five major variables: genetic background and familial history; life cycle events; dietary habits; use of exogenous estrogens; and psychological factors, including life stresses, anxiety or tension, and depression. Most of the variables are hypothesized to increase the risk of breast pathology by inducing physiological changes—specifically, by fostering endocrinopathy or immunosuppression. Experimental and epidemiological research pertaining to these factors is cited, and the relationship between fibrocystic disease and breast cancer is detailed. Implications of this synthesis of the literature for prevention of breast disease and rehabilitation of women with breast disease are described.

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