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Breast Cancer Research and Treatment
Published in: Breast Cancer Research and Treatment 1/2018

Open Access 01-01-2018 | Epidemiology

Severe depression more common in patients with ductal carcinoma in situ than early-stage invasive breast cancer patients

Authors: M. L. Gregorowitsch, H. J. G. D. van den Bongard, D. A. Young-Afat, J. P. Pignol, C. H. van Gils, A. M. May, H. M. Verkooijen

Published in: Breast Cancer Research and Treatment | Issue 1/2018

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Abstract

Purpose

Ductal carcinoma in situ (DCIS) is associated with an excellent prognosis; historical studies have shown similar levels of psychological distress in patients with DCIS and with early-stage invasive breast cancer (early-IBC). It is suggested that these results might have led to better patient education about prognosis after DCIS. This study reports the current levels of anxiety, depression, and health-related quality of life (HRQoL) in DCIS and early-IBC patients.

Methods

DCIS (n = 89) and early-IBC patients, T1-2N0, (n = 361) were selected from the UMBRELLA breast cancer cohort. Patient-reported outcomes were prospectively collected before the start of adjuvant radiotherapy (baseline) and at 3, 6, 12, 18, and 24 months thereafter. Mixed models were used to compare differences in levels of anxiety, depression, and HRQoL between DCIS and early-IBC patients.

Results

DCIS and early-IBC patients reported similar levels of anxiety, which were highest at baseline. Depression scores were comparable between groups, also after stratification by use of adjuvant chemotherapy. The proportion of patients reporting high-risk depression scores (i.e., Hospital Anxiety and Depression Sale score >8) was significantly higher among patients with DCIS at 6, 12 and 18 months, and this proportion increased over the first 18 months. Health-related quality of life was comparable between both groups.

Conclusion

Severe depression scores are more common in DCIS patients, despite their excellent prognosis. These results suggest that further improvement of patient education and effective patient doctor communication about the prognostic differences between patients with DCIS and invasive breast cancer is still highly needed.
Appendix
Available only for authorised users
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Metadata
Title
Severe depression more common in patients with ductal carcinoma in situ than early-stage invasive breast cancer patients
Authors
M. L. Gregorowitsch
H. J. G. D. van den Bongard
D. A. Young-Afat
J. P. Pignol
C. H. van Gils
A. M. May
H. M. Verkooijen
Publication date
01-01-2018
Publisher
Springer US
Published in
Breast Cancer Research and Treatment / Issue 1/2018
Print ISSN: 0167-6806
Electronic ISSN: 1573-7217
DOI
https://doi.org/10.1007/s10549-017-4495-y

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