A woman naps on a couch on a deck outsideShare on Pinterest
Experts say depression should be monitored after a breast cancer diagnosis. Kathrin Ziegler/Getty Images
  • Experts say depression is common among women who are diagnosed with breast cancer.
  • Researchers say having depression before or after a breast cancer diagnosis can increase a person’s risk of death from the disease.
  • Experts say the findings emphasize the importance of monitoring a person for depression after a breast cancer diagnosis.

A cancer diagnosis can often cause depression as well as anxiety and a host of other mental health issues.

A study published today in Cancer, a journal of the American Cancer Society, takes that a step further by looking at how depression may affect a woman’s chances of survival from breast cancer.

In the study, the researchers concluded that having depression before or after a breast cancer diagnosis was associated with a lower likelihood of survival.

Bin Huang, PhD, an associate professor at the University of Kentucky Markey Cancer Center, and his colleagues analyzed data from the Kentucky Cancer Registry to identify adult women diagnosed with primary invasive breast cancer from 2007 to 2011.

The team classified people in the study as having no depression diagnosis, depression diagnosis only before cancer diagnosis, depression diagnosis only after cancer diagnosis, or persistent depression defined as depression before and after cancer diagnosis.

The team also assessed the patients’ receipt of first course guideline-recommended treatment as indicated by the National Comprehensive Cancer Network breast cancer treatment guidelines.

Among 6,054 people in the study, the analysis indicated that 29% of the people in the study did not receive guideline-recommended breast cancer treatment.

Compared with people with no depression, Huang said that people with post-diagnosis only or persistent depression had a similar likelihood of receiving guideline-recommended treatment.

People in the study with depression pre-diagnosis had 25% lower odds of receiving guideline-concordant care. However, it’s important to note that this finding was only marginally significant.

Depression pre-diagnosis only and depression post-diagnosis only (but not persistent depression) were linked with worse survival compared with no depression.

The study authors reported that depression pre-diagnosis was associated with a 26% higher risk of death. A post-diagnosis of depression was associated with a 50% higher risk of death.

In addition, people who didn’t receive guideline-recommended treatment faced a 118% higher risk of death.

An analysis based off of one region found that compared to people residing in non-Appalachian Kentucky, people residing in Appalachia were 18% less likely to received recommended care. However, researchers did not find any significant differences in survival.

Huang said the most surprising result from this study is that patients with persistent depression did not experience worse survival compared with patients with no depression.

Given that under-diagnosis and under-treatment of depression are common among cancer patients, persistent depression could be an indication that a person’s depression may have been well managed, Huang noted.

Hence, this particular result suggests the importance of depression screening and management throughout a cancer patient’s care, he said.

Huang also said that population-based cancer registry data enhances population-based cancer outcomes research.

“Utilizing linked health claims data and cancer registry data in this study demonstrated the value of data linkages across various sources for examining potential health disparities and identifying where improvements in cancer care are needed,” he said in a press statement.

“More rigorous studies are needed in depression management and across various cancer sites and patient populations. Subsequently, results from these research studies may further shape policies and guidelines for depression management in cancer care,” he noted.

Huang added that oncology in general now has a better understanding of how to take care of this condition.

“It takes a team to collaboratively and comprehensively address these issues. But generally, we are better aware of mental health now,” he said.

Marianne Sarcich, a breast cancer survivor and national breast cancer advocate, said that depression is something that must be monitored from the first day of care.

She also noted that palliative care should be offered and should continue as long as is needed.

“Supportive care, also known as palliative care, is patient-centered care that is the ultimate in personalized medicine because it is about quality of life for that patient as defined by that patient,” Sarcich told Healthline.

“Starting at diagnosis, supportive care works alongside curative or active treatment, focusing on the whole patient,” she said. “From symptom management to psychosocial to spiritual. All of this to ease the physical and emotional burden that can come with diagnosis, treatment and recovery. In addition, supportive care encompasses the entire family, not just the patient.”

According to a recent update on global cancer statistics, female breast cancer has now surpassed lung cancer as the most commonly diagnosed cancer worldwide.

An estimated 2,261,419 new cases of breast cancer were diagnosed in women worldwide in 2020.

More women in the United States are diagnosed with breast cancer than any other type of cancer besides skin cancer, according to the American Cancer Society.

The disease accounts for 1 in 3 of new female cancers annually.