Survival After Early-Stage Breast Cancer of Women Previously Treated for Depression: A Nationwide Danish Cohort Study

Authors: Suppli, N. P. et. al.

Source: J Clin Oncol, doi: 10.1200/JCO.2016.68.8358

ascopubs.org/doi/full/10.1200/JCO.2016.68.8358

The association between depression and poor survival after breast cancer has been studied. One reason for the association may be that these women receive suboptimal care. The proof for this theory is minimal. The investigators accessed Danish national databases for this study. These databases had detailed information about breast cancer as well as depression diagnoses and treatments in the nation. Over 45,000 women were included. Breast cancer patients were placed in one of three categories: no history of depression, prior history of medical treatment for depression and prior hospital contact for depression.

Women who had used antidepressants or had been hospitalized for depression were less likely to receive standard breast cancer treatment compared to women with no depression diagnosis. Women who used antidepressants had worse overall and breast cancer-specific survival. These outcomes appeared to be directly related to women not receiving standard care. When women with depression did receive standard breast cancer treatment, their outcomes were equivalent to women with no history of depression. Apparently, the poorer outcomes with depression were not because these women presented with more advanced (neglected) disease but because they were not offered standard therapies.

This study from Denmark demonstrated the need to improve outreach to and follow up of women with depression who are diagnosed with breast cancer. There are opportunities to ensure that these women are offered, and adhere to, guideline therapies.