An Investigation of Alexithymia Personality Features Versus Outcome: A Prospective 25-year Follow-up Study in Women With Breast Cancer Symptoms

Anticancer Res. 2025 Nov;45(11):5085-5094. doi: 10.21873/anticanres.17849.

ABSTRACT

BACKGROUND/AIM: This study assessed the relationship between alexithymia (AT) and long-term outcomes in patients having breast carcinoma (BC) symptoms.

PATIENTS AND METHODS: A cohort of 115 women with BC symptoms (n=115) completed the Sifneos alexithymia inventory (SAI) scale and associations between SAI scale and long-term outcomes were analysed using survival models.

RESULTS: The SAI scores correlated with Beck Depression Inventory (BDI) (r=-0.379, p<0.001), Montgomery-Asberg Depression Rating Scale (MADRS) (r=-0-500, p<0.001) and Forsen psychological inventory (FI) levels 0-2 years pre-diagnosis (r=-0.320, p<0.001) and 2-6 years pre-diagnosis (r=-0.358, p<0.001). Women with BC exhibited significantly more AT features than non-BC patients, including alienation from their own body (p=0.004), alienation from own experience (p=0.003), impaired individuation (p=0.016), and deficits in self-experience (p=0.012). The 25-year relapse-free survival (RFS) rate did not differ significantly between the low SAI (<26) and the high SAI score (≥26) groups (54.0% versus 65.0%, log-rank p-value=0.273). The 25-year overall survival (OS) differed almost significantly between the low SAI (<26) and high SAI score (≥26) groups (59.5% versus 75.3%, log-rank p-value=0.07). Cox analysis suggested that the low SAI score (<26) is a significant unfavourable predictor of OS [hazard ratio (HR)=0.52, 95% confidence interval (CI)=0.28-1.04, p=0.06].

CONCLUSION: Higher AT, as measured by the SAI, is associated with poorer long-term survival and correlates with psychological distress in women with BC symptoms. Incorporating SAI assessment may aid in identifying patients at risk of adverse psychological and clinical outcomes.

PMID:41151869 | DOI:10.21873/anticanres.17849