Posttraumatic stress in breast cancer survivors diagnosed at a young age

Abstract

Objective: Young breast cancer patients experience greater psychosocial distress compared with older patients, which raises concern for their risk of posttraumatic stress disorder (PTSD). We sought to characterize the prevalence of clinically significant symptoms of PTSD and associated factors among breast cancer survivors diagnosed at a young age. Methods: The Young Women's Breast Cancer Study, an ongoing prospective cohort study, enrolled 1302 women diagnosed with breast cancer at age ≤ 40 between 2006 and 2016. Participants complete serial surveys, and we obtained additional information from medical record review. Socio-demographics, anxiety and depression, social support, and psychiatric co-morbidities and medications were assessed at study baseline (median, 5 months post-diagnosis). We defined a participant as having clinically significant posttraumatic stress symptoms (PTSS) by scoring ≥50 on the PTSD Checklist-Specific Version, administered on the 30-month survey. Results: Among 700 women with stage 1-3 disease, the prevalence of PTSS was 6.3% (95%CI = 4.5-8.1). In multivariable analyses, PTSS was significantly associated with anxiety (OR 12.43, 95%CI = 5.81-26.59, P < .0001) and stage 2 vs 1 disease (OR 2.26, 95%CI = 1.04-4.93, P = .04). PTSS was inversely associated with having a college degree (OR 0.29, 95%CI = 0.13-0.62, P = .002) and greater social support (OR 0.44, 95%CI = 0.21-0.94, P = .03). Conclusions: We found similar rates of cancer-related PTSS in breast cancer survivors diagnosed at a young age compared with the general breast cancer population despite their well-documented increased risk of overall distress. Nevertheless, factors associated with posttraumatic stress should be considered at diagnosis and in survivorship to identify young patients who may benefit from psychosocial resources.

Comparison of Prevalence and Risk Factors of PTSS Between Chinese Patients With Depression and Non-depressed Controls During COVID-19 Outbreak

“…Despite the SDS score, our study identified several other common correlates for PTSS in both patients with depression and non-depressed controls. We found that the IES-R total score was positively associated with SAS score in both depression and non-depression groups, which was consistent with previous studies on breast cancer survivors ( 53 ). Another study on American adolescents also showed that anxiety was the most common psychiatric comorbidities in hospitalized adolescent patients with PTSS ( 54 ).…”

Psychiatric comorbidities in cancer survivors across tumor subtypes: A systematic review

“…Whereas testicular cancer survivors showed a comparably low level of full PTSD with a prevalence of 4.5%[ 17 ], the two studies including melanoma patients showed numbers as high as 48%[ 14 , 27 ]. For breast cancer survivors, the prevalence ranged from 6.3%[ 16 ] to 18%[ 28 ].…”

Visual cues of the built environment and perceived stress among a cohort of black breast cancer survivors

“…The greater number of social stressors experienced by Black women has been hypothesized to influence breast cancer survival disparities through psychosocial stress and related physiologic effects ( Williams et al, 2016 ; Saini et al, 2019 ; Coughlin, 2019 ). Studies of stress among breast cancer survivors, however, have found little evidence of associations involving social factors, including race/ethnicity and socioeconomic status ( Golden-Kreutz et al, 2005 ; Syrowatka et al, 2017 ; Stanton et al, 2015 ; Vazquez et al, 2020 ). For example, Golden-Kreutz et al, found no correlation between race, educational attainment, or household income and perceived stress among women surgically treated for breast cancer.…”