Levels of Depression and Anxiety Post-Mastectomy in Breast Cancer Patients at a Public Sector Hospital in Karachi

Abstract

Background: There is a noticeable change in the approach with which women nowadays seek help for diseases like breast cancer, primarily due to awareness campaigns, but what happens after surgical procedures is of great significance too. This study focused on the several psychological connotations attached to mastectomy and how the patients cope. Objective: To understand the pattern of anxiety and level of depression among Pakistani patients undergoing mastectomy. Materials and Methods: The sample size consisted of 88 patients who had undergone mastectomy at the different surgical units of the Civil Hospital, Karachi, from January 2012-December 2014; The questionnaire was administered before they were discharged i.e. within 3 days of surgical procedures. The patients were asked if they were willing to participate in this study, those who agreed signed the consent form and then we preceded by asking questions with a standardized tool. A self made questionnaire was constructed keeping in mind the nature and specification of the disease, which consisted of 20 questions related to anxiety and depression, focusing on a mixture of psychological and physiological symptoms. Results: There were a total of 88 patients out of which 36 (41%) were aged 51 to 60 years, 24 (27.2%) of the patients were in the age category of 41 to 50 years, 17 aged 61 and above (19.3%) and only 11 (12.5%) 30-40 years of age, the youngest of all the age categories. The pattern of depression and anxiety was found to be similar among all age categories, severe depression and anxiety predominating over moderate level of such symptoms, with only relatively few patients sufering mild or no depression symptoms. Conclusions: It was concluded that going through mastectomy leads to moderate to severe levels of depression and anxiety, primarily because the females feel incomplete and insecure after losing a part of themselves.

Characteristics of Breast Cancer Patients Who Refuse Surgery

“…A previous study on patients with resectable pancreatic cancer showed that women had higher odds of refusing surgery (OR=1.52; 95% CI=1.33-1.73) when compared to men (3). Additionally, previous research has identified that body disfigurement caused by the surgery can affect the psychological state of female breast cancer patients (12,13).…”

Factors associated with Depression among Patients with Breast Cancer at Moi Teaching and Referral Hospital, Eldoret, Kenya

“…[27], worries regarding fear of death and disease recurrence, altered body image [22], alteration of sexuality and attractiveness. A study done in Karachi hospital found that going through mastectomy leads to moderate to severe depression among patients with breast cancer, this was primarily because one feels incomplete and insecure after losing a part of themselves Sara Khan et al, [28].…”

Psychological Comorbidity of Breast Cancer: A Cross-Sectional Study from Pakistan

“…Despite high prevalence of breast cancer in Pakistan, data on psychological comorbidities is limited and what is available is with a small sample size (Khan et al, 2016). Therefore, the present secondary analysis aimed at assessing prevalence of depression and anxiety in Karachi, the largest metropolitan city in Pakistan, and fifth largest city in the world and hence the findings may represent and highlight the needs of a large sized population.…”