The Effect of the Psychological Status of Breast Cancer Patients on the Shortterm Clinical Outcome after Mastectomy

Abstract

to analyze the effect of anxiety and depression on the postoperative complications and length of hospitalization of patients with breast cancer. Beck's Depression Inventory (BDI) and Hospital Anxiety and Depression Scale (HADS) were filled out by the patients pre-operatively. Patients were asked to rate their pain by the visual analogue scale (VAS) after surgery. Age, seroma volume, day of drain withdrawal, complications, and pathological stages were noted. The median age of 49 patients with the diagnosis of breast cancer was 51 (36-80). There was a significant correlation between the pain score and Beck, HADS, HADS (anxiety) and HADS (depression) (8 hours ; p = 0.021, 0.001, 0.004, 0.005 and 24 hours ; p = 0.005, 0.012, 0.006, 0.120). The mean HADS depression score in those patients with complications was 9.1 +/- 4.2 and that of patients with no complications was 6.6 +/- 3.1 (p = 0.047). The mean hospital stay of patients with a normal HADS score (< 19) was 2.9 +/- 1.1 days, whilst that of patients with an abnormal HADS score was 3.8 +/- 1.2 days (p = 0.016). Patients with abnormal HADS anxiety and abnormal HADS (total) scores had an earlier stage of breast cancer (p = 0.077, p = 0.063). The psychological status of breast cancer patients effects their postoperative recovery period and it is easy to diagnose these patients by some brief questionnaires.

Persistent Breast Pain Among Women With Histories of Breast-conserving Surgery for Breast Cancer Compared With Women Without Histories of Breast Surgery or Cancer

“…Thus, the relationship between depressive symptoms and persistent post-surgical pain continues to be difficult to clarify from a causal perspective. We also found that anxiety symptoms were higher among women with a history of breast cancer and persistent breast pain as compared to women without a history of breast cancer or breast surgery, consistent with other studies that reported an association between pain and anxiety [9, 20, 21, 27, 30, 31]; however, in this cross-sectional study it is not possible to say if anxiety was present prior to the development of persistent breast pain. More research is needed to improve understanding of the development of persistent breast pain over time and how it relates to psychosocial distress (e.g.…”

“…Several prior studies have found symptoms of depression to be associated with persistent breast pain in breast cancer survivors [20, 21], but this relationship has been inconsistent across studies [9, 22]. Pre-operative depression has been identified as a potential risk factor for the development of persistent post-surgical pain in longitudinal studies of patients undergoing orthopedic surgery[23], cardiac surgery[24], lumbar discectomy[25], and in women after breast cancer surgery[26-28].…”

Does Travel Distance Influence Length of Stay in Elective Colorectal Surgery?

“…Preoperative depression and anxiety in patients undergoing either breast surgery or thoracic surgery is known to result in increased los. 13,14 interestingly, there is a paucity of literature regarding the relationship between decreased los and overall patient satisfaction or postoperative anxiety levels in patients undergoing general surgery. 15 this study highlights the significant relationship between los and patient distance traveled, but it does not look at the qualitative factors and opinions of health care workers and patients in the discharge decision-making process.…”

Persistent pain in postmastectomy patients: Comparison of psychophysical, medical, surgical, and psychosocial characteristics between patients with and without pain

“…Increasingly, psychosocial factors such as anxiety, depression, sleep disturbance, and catastrophizing have proven to be important contributors to the development of persistent pain [69,72,77]. When measured prospectively, these predict the trajectory of acute pain or analgesic consumption after breast cancer surgery [55,56,81] and, in other settings, also predict the development of chronic orofacial pain [25] and widespread pain [33].…”