What role for education, nutrition, and psychosocial support in early breast cancer?

The usefulness of educational and nutritional interventions targeted at younger women with early-stage breast cancer are not always helpful, and their effectiveness is moderated by a range of variables, particularly a pessimistic disposition, unmitigated communion, and negative social interaction, according to a report published in the Dec. 20 issue of the Journal of Clinical Oncology.

Michael F. Scheier, PhD, of Carnegie Mellon University in Pittsburgh, and colleagues conducted a study of 252 women younger than 51 with early-stage breast cancer who had completed adjuvant therapy within the previous 2 months. They were randomized into a nutritional intervention group, an educational intervention group, and a control group, and moderating variables in four categories were assessed: personality, social support and environment, demographics, and disease- and treatment-related measures.

The factors most likely to moderate the success of interventions were psychosocial, and the impact was limited to patients in the nutrition intervention group. Those with lower psychosocial resources experienced the greatest benefit while those with a greater amount of psychosocial resources gained the least from this intervention.

"Future trials of this type should stratify by or select for these moderating variables…to establish more firmly their role in responses to psychosocial interventions," the authors conclude.

Scheier MF, Helgeson VS, Schulz R, et al. Moderators of interventions designed to enhance physical and psychological functioning among younger women with early-stage breast cancer. J Clin Oncol. 2007;25:5710-5714.