This perspective on Williams et al. (beginning on p. 850 in this issue of the journal) examines the connections between biological responses activated during psychosocial stress and mammary tumorigenesis. Experiments in mouse models of cancer are identifying aspects of tumor biology that may be regulated by hormones such as glucocorticoids released during psychosocial stress. Our growing understanding of the actions of glucocorticoids on breast tumors could lead to important changes in cancer treatment.Psychosocial factors have long been suspected to have important effects on human health (1). Epidemiologic studies of the relationships between breast cancer and psychosocial stress, however, have produced maddeningly inconsistent results. Some studies indicate that depression and lack of social support may be risk factors for breast cancer development and progression (2, 3), whereas others report no link between social stress and breast cancer incidence (4). A weakness common to all of these studies is in not having measured individual physiologic responses to stress. The hypothalamic-pituitary-adrenal (HPA) axis, which stimulates the release of glucocorticoids and epinephrine, is an important stress-activated system. The HPA axis has become a focal point for understanding the effects of stress on health because of its ability to affect a wide range of physiologic processes, including immune function (5). In a natural context, activation of the HPA axis prepares an individual to "fight or flee" from a challenging situation (6). The HPA axis, however, could be chronically activated in the absence of a natural challenge, and it has been proposed that many of the deleterious effects of stress on human health may result from this chronic activation (7). Psychosocial stress in the forms of anxiety, depression, and interpersonal conflict could activate the HPA axis, causing the release of glucocorticoids and epinephrine.It is becoming increasingly clear that individuals vary in their physiologic responses to stressful situations (8). Therefore, stressful life events are not universally translated into physiologic signals that could affect cancer biology. This may partially explain why epidemiologic studies examining the association between stress and breast cancer have produced such heterogeneous results. Two general approaches could help resolve the question of whether psychosocial stress indeed affects physiologic processes regulating the development and/or progression of cancer. First, epidemiologic studies need to characterize individual variation in how stressful life events translate into biological signals such as glucocorticoids. Although individual differences in stress hormone responses are not normally collected within large-scale epidemiologic studies, it will be difficult for the field to move forward without this critical information. Second, mechanistic studies can test whether biological signals (such as glucocorticoids) activated during stress regulate cancer biology.The Conzen group is a leade...