Biological, physical, mental and social dimensions of breast cancer: information based on routine case notes

551 patients were diagnosed with breast cancer in Tampere University Hospital district, Finland between 1977 and 1980. The number of follow-up visits during the first 5 years was 8248. The biological, physical, mental and social dimensions of breast cancer were measured by death, recurrence of disease, Karnofsky score, physical or mental symptoms, and sick leave. The prevalence rates of an event and the incidence rates of the appearance or disappearance of an event were used to determine the indicators for these different dimensions of breast cancer. The study was based on hospital case notes. Data on death, recurrence, sick leave and Karnofsky score were well recorded, but physical or mental symptoms were recorded infrequently. There was a 4-fold difference between the highest and lowest prevalence for the different dimensions, but the trends were similar by follow-up time. The variation was also large for the incidence rates but the trends differed with length of follow-up time. The biological, physical, mental and social consequences of breast cancer differ in magnitude and have different trends over time, indicating that breast cancer is a different disease depending on the dimension and on the indicator under consideration.