Characteristics of women at risk for psychosocial distress in the year after breast cancer.

Schag, C. A. C.; Ganz, Patricia A.; Polinsky, Margaret L.; Fred, C.; Hirji, Karim F.; Petersen, Laura

doi:10.1200/jco.1993.11.4.783

Cited by 246 publications

(142 citation statements)

References 29 publications

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“…In addition to global QOL, assessment of emotional functioning shows low levels at baseline too, with no significant changes during follow-up in both groups. An explanation for low levels at baseline is that patients being informed about the breast cancer diagnosis before surgery induced psychological distress (Fallowfield et al, 1986;Ganz et al, 1992;Coscarelli Schag et al, 1993). In this study the Karnofsky performance status score was, for most patients, over 90 at baseline and showed no differences in patients' physical condition in both groups during follow-up.…”

Section: Discussionmentioning

confidence: 55%

Comparison of quality of life and arm complaints after axillary lymph node dissection vs sentinel lymph node biopsy in breast cancer patients

Peintinger¹,

et al. 2003

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The sentinel lymph node biopsy (SLNB) represents a minimal invasive surgical method for axillary staging in patients with primary breast cancer. In a prospective study, evaluation of quality of life (QOL) and arm morbidity was performed before surgery on a total of 56 breast cancer patients. The EORTC QLQ-C30 and EORTC QLQ-BR23 questionnaires were used for QOL assessment. Assessment of pain was additionally observed using the McGill Pain Questionnaire. Arm mobility was observed by goniometric measurement of arm movement. Data were collected before surgery (t1), 1 week after discharge (t2) and 9 -12 months after surgery (t3). The type of axillary surgery does not seem to affect global QOL at a short-time follow-up, but patients recover sooner after SLNB. Body image and sexual functioning remain stable in both types of axillary surgery. Arm/shoulder pain was reported in 36% of patients after SLNB in comparison to 68% receiving axillary lymph node dissection (ALND), and 'numbness' was reported only in 4% of patients in the SLNB group vs 19.3% after ALND. Abduction, flexion and horizontal adduction of the affected arm show significant impairment after ALND. Breast cancer patients should be counselled about the benefits of SLNB over ALND concerning QOL and postsurgery side effects in a short-term follow-up. Axillary lymph node dissection (ALND) in breast cancer patients still represents the routine surgical method for axillary staging. Although the axillary node status is the most important prognostic factor for recurrence and survival (Fisher et al, 1984;Carter et al, 1989) and information obtained by axillary dissection is useful for planning adjuvant treatment, it is associated with substantial morbidity (Kissin et al, 1986;Ivens et al, 1992;Keramopoulos et al, 1993;Hack et al, 1999;Kakuda et al, 1999) and psychological distress (Maunsell et al, 1993;Tobin et al, 1993;Shimozuma et al, 1999). Hack et al, showed arm/shoulder pain, weakness or numbness in 72% and impaired range of motion in 73% of breast cancer patients after ALND, whereas high levels of quality of life (QOL) were reported. Moderate to severe pain was reported between 20, 23 and 32% (Van Dam et al, 1993;Kuehn et al, 2000;Ververs et al, 2001) and was not significantly related to time since surgery. Other reports suggest that arm problems after ALND are associated with a negative effect on the overall QOL of breast cancer patients (Maunsell et al, 1993;Kuehn et al, 2000). As a result of the need to reduce axillary morbidity, many investigations have been performed on sentinel lymph node biopsy (SLNB), an alternative procedure. Using vital dye and/or radiocolloid, the sentinel node/s as the first lymph node to receive lymphatic drainage from the primary tumour can be identified by a minimal invasive surgical technique. Recently, published data showed no sensory morbidity after SLNB (Giuliano et al, 2000) at a median follow-up of 39 months. Schrenk et al (2000) reported less postoperative arm pain, numbness and arm motion restriction after SLNB at a foll...

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Section: Discussionmentioning

confidence: 55%

Comparison of quality of life and arm complaints after axillary lymph node dissection vs sentinel lymph node biopsy in breast cancer patients

Peintinger¹,

et al. 2003

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“…Some data suggest that the onset of mood disorders may vary according to the stage of cancer treatment, 20,31 staging 32 or type of treatment 33,34 while others found no cancer-specific influence. 12,15,16 Breast cancer and depression are public health problems.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of Major Depression in Patients With Breast Cancer

Carvalho

Bezerra

Freitas

et al. 2015

J. Hum. Growth Dev.

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ABSTRACT:Introduction: breast cancer is one of the main causes of death among women in Brazil and worldwide. The diagnosis of breast neoplasms usually represents an emotional burden, and it may lead to adjustment reactions and even be the trigger for affective disorders (mainly depression), anxiety or psychosis. The Beck Depression Inventory (BDI) is one of the most used mechanisms for the evaluation of depression in research and in clinics. Depression prevalence in patients with cancer varies from 3% to 55% among different studies. Methodological variation, different instruments to assess depression and different cut-off points for diagnosis contribute to the huge discrepancy in current findings. In general, the more specifically depression is defined and evaluated, the lower the rates of prevalence are reported. Many articles fail to demonstrate a statistical significance in the relationship between depression and cancer-specific factors. This suggests that risk factors for depression in those patients are more related to the patient as contextual variables and premorbid factors of personality -and not to the cancer or its treatment. Objective: to determine the prevalence of major depression in women with breast cancer. Methods: a cross-sectional study was conducted in women with breast cancer. The sample consisted of 51 patients who answered the Beck Depression Inventory (BDI). The presence of depression was considered in cases where the scores were above 20. A questionnaire with additional data about the patients such as age, marital status, ethnicity, education, family income, family history of depression and breast cancer, and cancer-related variables including staging, months since diagnosis, treatment modality, type of surgery, alopecia occurring were used. Descriptive analysis and test of association (chi-square) were conducted. Results: the prevalence of major depression was 5.9%, similar to that observed in community samples. Subsyndromal depressive symptoms had a score of 21.6% (BDI scores from 16 to 20). Chi-square test was conducted and showed no statistically significant relationship between the classification of BDI and the variables tested (characteristics related to patient and cancer-specific). This indicates that the isolated context of the variables does not influence the event of depression. Conclusion: the prevalence of major depression in women with breast neoplasms was 5.9%.

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“…Although this study did not investigate risk factors within the cohort, other studies have identified clear risk factors for depression and anxiety among cancer patients. Such risk factors tend to be more closely related to the patient than factors surrounding disease or treatment and include lack of an intimate confiding relationship, marital issues, and history of depression or previous psychological treatment [1,[24][25][26].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of screening instruments for depression and anxiety in breast cancer survivors

Alexander

Palmer

Stone

2009

Breast Cancer Res Treat

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Although cases of anxiety and depression postbreast cancer can be reliably identified using a structured psychiatric interview, such interviews are time consuming for both practitioner and patient and effective screening tools would increase detection rates. The purpose of this study was to evaluate the effectiveness of the Edinburgh Depression Scale (EDS) and the Hospital Anxiety and Depression Scale (HADS) in screening for depression and anxiety in a population of breast cancer survivors. For this purpose, The Structured Clinical Interview for the Diagnostic and Statistical Manual of mental disorders was administered to 200 breast cancer survivors to identify those suffering from an anxiety and/or depressive disorder. All study participants also completed the EDS and the HADS. Using the recommended cut-off score of [12 to screen for depression, the sensitivity and specificity of the EDS were found to be 72 and 90%, respectively. Lowering the cut-off score to [9 resulted in a sensitivity of 94% and a specificity of 78%. At the recommended cut-off score of [10, the HADS had a sensitivity of 50% and a specificity of 97% for depression, and a sensitivity of 71% and a specificity of 86% when screening for anxiety. A HADS total score (HADS-T) of [13 and an EDS of [9 had sensitivities of 96 and 91% and specificities of 74 and 84%, respectively, in screening for anxiety and/or depression. In conclusion, the study demonstrated that both the EDS and HADS can be used reliably as screening tests for anxiety and depression in this cohort. In both cases, a lower cut-off score than normally recommended delivers optimal screening properties.

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Characteristics of women at risk for psychosocial distress in the year after breast cancer.

Abstract: The detailed listing of problems provided by the CARES may be helpful to clinicians in their interactions with patients. The need for preventive and early intervention for the at-risk patients is underscored.

Cited by 246 publications

References 29 publications

Comparison of quality of life and arm complaints after axillary lymph node dissection vs sentinel lymph node biopsy in breast cancer patients

Comparison of quality of life and arm complaints after axillary lymph node dissection vs sentinel lymph node biopsy in breast cancer patients

Prevalence of Major Depression in Patients With Breast Cancer

Evaluation of screening instruments for depression and anxiety in breast cancer survivors

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