Well-educated women and those who live alone are emotionally the hardest hit by breast cancer, according to the findings of a new Australian study announced during October's Breast Cancer Awareness Month.

The MBF Foundation Health and Wellbeing after Breast Cancer Study, undertaken by Monash University Medical School's Women's Health Program, found that older women tended to experience lower levels of overall wellbeing compared to women of similar age in the community two years after their diagnosis.

"Up until now, there has been uncertainty about exactly what the impact of being diagnosed with breast cancer is in terms of mood and wellbeing over time. In our study, we found that two years post diagnosis women with breast cancer were not more likely to be depressed but were more likely to experience a lowered sense of control over their life, and lower general health, with lessened vitality being limited to older women," explains Dr Susan R Davis, Professor of Women's Health, Monash University Medical School, who was involved in the study.

"The experience of having breast cancer is a personal one and is often accompanied by very complex emotions due to the fact that it strikes at a woman's very sense of self, purpose and sexuality."

Co-chief investigator of the study, Associate Professor Robin Bell, added: "That women living alone were more likely to have a lower wellbeing is a novel and important finding and would suggest that such women may benefit by targeted provision of social support."

More educated women are likely to be the best informed about their breast cancer and treatment, and their lower wellbeing results may reflect greater anxiety over decision making and their difficulty coping with a sense loss of control over their health and wellbeing.

"We would encourage health care providers to be sensitive to the fact that more highly educated women may deal less well with psychological aspects of their disease than others," said Professor Davis.

Breast cancer is the most common cancer among women in Australia, affecting one in nine women by the age of 85 years, and is responsible for around 2,600 deaths annually. With improvements in detection and treatment of breast cancer, 87 per cent of women affected survive five years or more from the time of detection.

"At MBF Foundation we are all for women becoming advocates for their breast cancer and their health in general but, as this study has shown, it is important that providing accurate information isn't at the expense of supporting their emotional needs," commented Dr Christine Bennett, Bupa Australia Chief Medical Officer and Chair of the MBF Foundation steering committee, which has committed $300,000 to fund the study.

"As survival prospects for women with breast cancer continue to improve, we shouldn't lose sight of the fact that each woman's journey and coping mechanisms are different. We know from listening to the women in the study, that it is common for breast cancer survivors to experience a range of emotions and concerns once treatment ends. Indeed, some women, report experiencing feelings of isolation and abandonment once their regular appointments with their medical team stop," added Dr Bennett.

On a positive note, the study found that women's wellbeing two years out from being treated for the disease was overall only modestly lower than for Australian women in general.

Women who are struggling with their emotions following breast cancer treatment may benefit from sharing their feelings with those close to them and discussing their concerns with a health professional or breast cancer support group.