Depression May Affect Survival in Breast Cancer

The use of antidepressants before diagnosis of early-stage breast cancer may contribute to poor overall survival and breast cancer-specific survival rates, according to an article published in the Journal of Clinical Oncology.¹

To determine whether there is a causal relationship between depression and survival in breast cancer, researchers identified 45,325 patients from the Danish Breast Cancer Group database, of whom 38,513 were not treated for depression before diagnosis, 6068 of whom were treated with antidepressants before diagnosis, and 744 of whom had previous hospital contact for depression.

Being treated with antibiotics or having hospital contact for depression increased a patient’s risk of not being allocated to guideline treatment. Women who took antidepressants before diagnosis had worse overall and breast-cancer specific survival.

Patients who either took antidepressants or had previous hospital contact for depression had a much greater suicide risk, though the authors claim that this risk may be similar among those without breast cancer.

The authors note that, in contrast with a similar study about patients with breast cancer in the Medicare setting, the present study reported higher breast cancer-specific survival rates, which may be related to the free medical care offered to Danish residents.

It was concluded that patients with depression who followed treatment guidelines had survival rates similar to those of patients without depression. The study results therefore suggest that clinicians ought to pay special attention to patients with breast cancer with a history of depression to ensure that treatment guidelines are being followed. 

Reference

1. Suppli NP, Johansen C, Kessing LV, et al. Survival after early-stage breast cancer of women previously treated for depression: a nationwide Danish cohort study. J Clin Oncol. 2016 Nov 14. doi: 10.1200/JCO.2016.68.8358 [Epub ahead of print]