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Waiting is the Hardest Part in Biopsies
Date:2/24/2009

s from the saliva of 126 women, 18 to 86 years old, each day for five days after they had undergone a large-core breast biopsy.

They then compared cortisol levels among women who did not yet know the outcome of the biopsy ("uncertain group"), women who had a diagnosis of cancer ("known malignant group") and women who were relieved to know they did not have cancer ("known benign group").

Women learned their outcome between one and six days after the procedure.

The mean cortisol "slope" for women in the uncertain group was flatter than that of women who had a benign result but similar to that for women who had learned they had cancer.

"Normally, cortisol levels are high in the morning and get lower during the day, so what really counts is the slope over the daytime," Lang explained. "The cortisol mechanism is set up for responding to acute stress so we can adapt quickly, like fight or flight. That's a good thing. But if the system gets overstressed, then you don't react to quick things that happen in daily life in an appropriate fashion."

"It's not like this fine-tuned Swiss clock anymore," she said.

Everything from wound healing to blood sugar, blood pressure and immune defense can be affected if the mechanism that regulates the cortisol system is impaired.

"Particularly now, in these times of uncertainty, let's acknowledge that uncertainty can wreck your immune system," Lang said.

More information

The Radiological Society of North America has more on breast cancer and breast imaging techniques.



SOURCES: Elvira V. Lang, M.D., associate professor, radiology, Harvard Medical School, Boston; Jay Brooks, M.D., chairman, hematology/oncology, Ochsner Health System, Baton Rouge, La.; March 2009, Radiology


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