A prospective, multidisciplinary, 5-year study of 69 consecutive female patients with early (T0,1N0,1M0) breast cancer was conducted. Patients' psychological responses to the diagnosis of cancer were assessed 3 months postoperatively. These responses were related to outcome 5 years after operation. Recurrence-free survival was significantly common among patients who had initially reacted to cancer by denial or who had a fighting spirit than among patients who had responded with stoic acceptance or feelings of helplessness and hopelessness.