This study tested an assumption of the theoretical hierarchy of defenses: denial reflects primitive ego development. The study hypothesized a positive relationship between extreme denial and immature object relationship functioning. Twenty breast cancer patients who demonstrated extreme denial and delayed help-seeking were compared on a measure of object relations with a group of 30 similar patients who did not manifest denial or delay. The central hypothesis was not supported, although trends suggested possible validity. Further study may improve our understanding of the mechanisms which influence symptom recognition, help-seeking, and emotional adjustment to cancer.