Background. The study examined the role of parental death and chronic depression with severe episodes in affecting risk of breast cancer. This avenue of research is in accord with oncology findings, which suggests that causative factors of breast cancer occur and develop over a period of 20 years or longer.

Methods. Participants consisted of 1213 women in the Baltimore Epidemiologic Catchment Area study surveyed in 1980 and followed through 1994–1995. They were assessed for depressive and anxious disorders, paternal death in childhood and relatively recent adverse life events prior to cancer hospitalization.

Results. In the course of the study, 29 women were hospitalized for breast cancer and 10 died of breast cancer. The psychosocial variables that predicted increased risk of breast cancer were maternal death in childhood (OR = 2·56, P < 0·001) and chronic depression with severe episodes (OR = 14·0, P < 0·001). Neither relatively recent life events nor other depressive and anxiety disorders were associated with increased risk. Maternal death and chronic depression with severe episodes were reported to have occurred at least 20 years prior to breast cancer hospitalization.

Conclusions. Maternal death and chronic and severe depression occurred at least 20 years prior to breast cancer hospitalization and could have been involved in the causation or facilitation of cancer development. The authors suggest that meta-analysis of other prospective studies are needed to create larger groups of individuals with these stresses to confidently establish these variables as risk factors.