Depression, Antidepressant Use, and Breast Cancer Risk in Pre- and Postmenopausal Women: A Prospective Cohort Study

Reeves, Katherine W.; Okereke, Olivia I.; Qian, Jing; Tamimi, Rulla M.; Eliassen, A. Heather; Hankinson, Susan E.

doi:10.1158/1055-9965.epi-17-0707

Cited by 21 publications

(14 citation statements)

References 42 publications

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“…Originally, investigators believed there might be a correlation between depression, anti-depressants, and breast cancer. Studies have shown a psychological benefit to prescribing anti-depressant medications to women with breast cancer [ 21 , 22 ]. Depression is even more prevalent in patients diagnosed with cancer, which may influence QOL measures following breast reconstruction.…”

Section: Discussionmentioning

confidence: 99%

The Effects of Depression and Anti-Depressants on Quality of Life After Breast Reconstruction: A Post-Hoc Analysis

Klifto¹,

Bekheet²,

Manahan³

et al. 2021

Cureus

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BackgroundA personal history of depression prior to breast cancer diagnosis and its effect on post-diagnosis quality of life (QOL) in women undergoing breast reconstruction is relatively unknown. We performed the current study to determine if depression alters QOL for patients who undergo breast reconstruction by assessing the pre-to-post-operative change in patient-reported BREAST-Q scores. MethodologyWe conducted a single-center, post-hoc analysis of 300 patients with completed BREAST-Q data who underwent breast reconstruction from November 2013 to November 2016 following a diagnosis of breast cancer. Patients completed the BREAST-Q at four time points: pre-operatively, six weeks following tissue expander (TE) insertion for patients undergoing staged reconstruction, and six and 12 months following the final reconstruction. Medical records were reviewed to identify patients who had a pre-cancer diagnosis of clinical depression and/or anti-depressant medication use. BREAST-Q scores were compared between groups and within groups. Groups compared were the depression (n = 50) and no depression (n = 250) patients, along with anti-depressant (n = 36) and no anti-depressant (n = 14) use in the depression group. ResultsWithin-group Sexual Well-being scores at the six-week post-TE follow-up for patients in the depression group (median = 37, interquartile range [IQR] = 25-47) were significantly lower (p < 0.01) than the scores for patients in the no depression group (median = 47, IQR = 39-60). There were no statistically significant differences in BREAST-Q scores in other domains. When compared to patients diagnosed with depression who were not taking anti-depressants, anti-depressant medication use did not result in statistically significant higher BREAST-Q scores, although Satisfaction With Breasts six months post-operatively, Psychosocial Well-being at six weeks post-TE, Sexual Well-being at six weeks post-TE and six months postoperatively were clinically higher in patients taking anti-depressants for depression. ConclusionsPatients with a diagnosis of depression prior to breast cancer had lower BREAST-Q Sexual Well-being scores in the six-week TE group with or without anti-depressant medication. Patients with a pre-cancer diagnosis of depression considering TEs may benefit from additional counseling prior to breast reconstruction or electing a different method of breast reconstruction. Anti-depressant medications may provide clinically higher BREAST-Q scores in patients with a pre-cancer diagnosis of depression. Adding an anti-depressant medication to a patient's treatment plan may provide additional benefits. Larger samples are required to properly determine the impact of anti-depressant medications on BREAST-Q scores in patients with a precancer diagnosis of depression.

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Section: Discussionmentioning

confidence: 99%

The Effects of Depression and Anti-Depressants on Quality of Life After Breast Reconstruction: A Post-Hoc Analysis

Klifto¹,

Bekheet²,

Manahan³

et al. 2021

Cureus

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“…It is worth noting that our study found an increased risk of hormone-related cancers. Although some previous studies didn't report signi cant associations between depression and hormone-related cancers [10,11,33,34], several studies identi ed a signi cant association between depression and hormone-sensitive cancers, including breast, ovarian, uterus, cervical, and prostate cancers [8, 25,26,35]. The different results across studies may be attributable to patient heterogeneity, cultural factors, socio-economic levels, and the state of medical care [36].…”

Section: Discussionmentioning

confidence: 99%

Association of Depressive Symptoms with Cancer Risk in Middle-Aged and Older Chinese Adults: A Longitudinal Cohort Study

Sheng

Liu

Song

et al. 2021

Preprint

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Aims. Although, the association between depression and cancer has already been very well studied, but studies about depressive symptoms and cancer development are scarce and inconclusive among Chinese adults. We aimed to investigate whether the severity of depressive symptoms is associated with total and site-specific cancer risk in a nationally representative sample of middle-aged and older Chinese adults. Methods. This study was based on the China Health and Retirement Longitudinal Study (CHARLS), which was initiated in 2011 and followed up to 2018. We included 11,974 individuals aged 45 years or older with complete information about depressive symptoms and no history of cancer at baseline. Depressive symptoms were assessed using the validated 10-item of Center for Epidemiologic Studies Depression Scale (CES-D). Incident cancer cases were documented in the biennial self-reported questionnaires. The multivariable Cox proportional hazards model was used to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs). Results. Of 11,794 individuals included in the analysis, 51.72% were women. After a median follow-up of 7.0 years, 265 incident cancer cases were identified. Overall, there was a significant positive association between CES-D score and cancer risk (HR 1.02, 95%CI 1.00-1.05, P=0.03). Severe depressive symptoms were associated with a 75% increased cancer risk (HR 1.75, 95%CI 1.10-2.78). Such associations were evident among women rather than men. In the cancer-specific analysis, the association of severe depressive symptoms and cancer risk was more pronounced for female hormone-related cancers (HR 5.58; 95% CI 2.70-11.54). Conclusions. The findings imply that individuals with severe depressive symptoms could be considered as high-risk population in cancer screening programs.

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“…18 A previous review found that shortterm and/or low-dose antidepressant use increased the risk of breast and ovarian cancer. 42 More recently however, a prospective cohort study, within the Nurses' Health Study (USA), found no associations for breast cancer 43 and a nationwide registry-based case-control study from Denmark found a negative association between SSRIs and epithelial ovarian cancer. 44 To our knowledge, this is the first observational study investigating the relation between antidepressants and melanoma risk.…”

Section: Discussionmentioning

confidence: 99%

<p>Use of Antidepressants and Risk of Cutaneous Melanoma: A Prospective Registry-Based Case-Control Study</p>

Berge¹,

Andreassen²,

Stenehjem³

et al. 2020

CLEP

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Purpose: Melanoma is the cancer with the most rapidly rising incidence rate in Norway. Although exposure to ultraviolet radiation (UVR) is the major environmental risk factor, other factors may also contribute. Antidepressants have cancer inhibiting and promoting side effects, and their prescription rates have increased in parallel with melanoma incidence. Thus, we aimed to prospectively examine the association between use of antidepressants and melanoma by using nationwide data from the Cancer Registry of Norway, the National Registry, the Norwegian Prescription Database and the Medical Birth Registry of Norway. Patient and Methods: All cases aged 18-85 with a primary cutaneous invasive melanoma diagnosed during 2007-2015 (n=12,099) were matched to population controls 1:10 (n=118,467) by sex and year of birth using risk-set sampling. We obtained information on prescribed antidepressants and other potentially confounding drug use (2004-2015). Conditional logistic regression was used to estimate adjusted rate ratios (RRs) and 95% confidence intervals (CIs) for the association between overall and class-specific use of antidepressants and incident melanoma. Results: Compared with ≤1 prescription, ≥8 prescriptions of antidepressants overall were negatively associated with melanoma (RR 0.81 CI 0.75-0.87). Class-specific analyses showed decreased RRs for selective serotonin reuptake inhibitors (RR 0.82 CI 0.73-0.93) and mixed antidepressants (RR 0.77 CI 0.69-0.86). The negative association was found for both sexes, age ≥50 years, residential regions with medium and highest ambient UVR exposure, all histological subtypes, trunk, upper and lower limb sites and local disease. Conclusion: Use of antidepressants was associated with decreased risk of melanoma. There are at least two possible explanations for our results; cancer-inhibiting actions induced by the drug and less UVR exposure among the most frequent users of antidepressants.

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Depression, Antidepressant Use, and Breast Cancer Risk in Pre- and Postmenopausal Women: A Prospective Cohort Study

Cited by 21 publications

References 42 publications

The Effects of Depression and Anti-Depressants on Quality of Life After Breast Reconstruction: A Post-Hoc Analysis

The Effects of Depression and Anti-Depressants on Quality of Life After Breast Reconstruction: A Post-Hoc Analysis

Association of Depressive Symptoms with Cancer Risk in Middle-Aged and Older Chinese Adults: A Longitudinal Cohort Study

<p>Use of Antidepressants and Risk of Cutaneous Melanoma: A Prospective Registry-Based Case-Control Study</p>

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