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Psychosocial stress is associated with benign breast disease in young Chinese women: results from Project ELEFANT

Barrow, Timothy, Peng, Cheng, Wilson, Ander, Wang, Hao, Liu, Hongbin, Shen, Lilin, Tang, Nai-jun, Sae-Lee, Chanachai, Li, Peng-hui, Guo, Liqiong and Byun, Hyang-Min (2019) Psychosocial stress is associated with benign breast disease in young Chinese women: results from Project ELEFANT. Breast Cancer Research and Treatment, 173 (1). pp. 217-224. ISSN 1573-7217

Item Type: Article


Psychosocial stress, including bereavement and work-related stress, is associated with the risk of breast cancer. However, it is unknown whether it may also be linked with increased risk of benign breast disease (BBD).

Our study leveraged 61,907 women aged 17-55 years-old from the Project ELEFANT study. BBD was diagnosed by clinician. Self-reported data on psychosocial stress over a ten-year period was retrospectively collected from questionnaires and categorised by cause (work, social and economic) and severity (none, low, and high). Odd ratios (ORs) for the development of BBD were estimated using logistic regression. The model was adjusted for age, BMI, TSH levels, smoking, alcohol consumption, family history, age of menarche, oral contraceptive usage, education and occupation.

Within our study, 8% (4,914) of participants were diagnosed with BBD. Work-related stress (OR = 1.57, 95% confidence interval [CI] = 1.46 - 1.69) and financial stress (OR = 1.34, 95% CI = 1.24 - 1.44) were significantly associated with BBD incidence, with a smaller but still significant association with social stress (OR = 1.11, 95% CI = 1.01 - 1.21). The associations remained significant after exclusion of participants with first- and second-degree family history of breast disease. The presence of multiple forms of stress did not synergistically increase risk. The neutrophil lymphocyte ratio (NLR), a marker of systemic inflammation and prognostic marker for breast cancer, was not associated with BBD.

Psychosocial stress, particularly work-related and financial stress, is associated with increased risk of benign breast disease among young Chinese women.

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Depositing User: Timothy Barrow


Item ID: 9995
Identification Number:
ISSN: 1573-7217
Official URL:

Users with ORCIDS

ORCID for Timothy Barrow: ORCID iD

Catalogue record

Date Deposited: 01 Oct 2018 08:28
Last Modified: 18 Dec 2019 16:07


Author: Timothy Barrow ORCID iD
Author: Cheng Peng
Author: Ander Wilson
Author: Hao Wang
Author: Hongbin Liu
Author: Lilin Shen
Author: Nai-jun Tang
Author: Chanachai Sae-Lee
Author: Peng-hui Li
Author: Liqiong Guo
Author: Hyang-Min Byun

University Divisions

Faculty of Health Sciences and Wellbeing
Faculty of Health Sciences and Wellbeing > School of Nursing and Health Sciences


Sciences > Biomedical Sciences
Sciences > Health Sciences

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