Inclusion Criteria:

Women were eligible for the study if they had documented metastatic or recurrent breast
cancer, were proficient enough in English to be able to complete questionnaires and
participate in a support group, were living in the Greater San Francisco Bay Area, and had
a Karnofsky score of at least 70%.19 Exclusion Criteria:

Women were excluded if they had any of the following risk factors: positive
supraclavicular lymph nodes as the only metastatic lesion at the time of initial
diagnosis; active non-breast cancers within the past 10 years; or other concurrent medical
conditions likely to influence short-term survival. Basal cell or squamous cell
carcinomas of the skin, in situ cancer of the cervix, or melanoma with a Breslow depth
less than 0.76 mm were allowed.