MONDAY, April 17, 2023 (HealthDay News) — Patients with depression only in the period before breast cancer diagnosis have lower odds of receiving guideline-recommended treatment and have worse survival, according to a study published online April 17 in Cancer.

Feitong Lei, Ph.D., from the University of Kentucky in Lexington, and colleagues identified women diagnosed with primary invasive breast cancer who were aged 20 years or older in 2007 to 2011 to examine the impact of depression on cancer treatment and survival. Patients were categorized as having no depression, depression before cancer diagnosis only, depression after cancer diagnosis only, or persistent depression.

Overall, 4.1, 3.7, and 6.2 percent of the 6,054 eligible patients had persistent depression, depression prediagnosis only, and depression postdiagnosis only, respectively. The researchers found that 29.2 percent of the patients did not receive guideline-recommended cancer treatment. The odds of receiving guideline-recommended treatment were lower in patients with depression only in the prediagnosis period (odds ratio, 0.75; 95 percent confidence interval, 0.54 to 1.04), but not in those with depression only in the postdiagnosis period or persistent depression compared with those with no depression. Worse survival was seen in association with depression postdiagnosis only and depression prediagnosis only (hazard ratios [95 percent confidence intervals], 1.51 [1.24 to 1.83] and 1.26 [0.99 to 1.59], respectively). Survival did not differ significantly for patients with persistent depression and those with no depression.

“Depression screening and management is important for breast cancer patients, especially for those who have a prior diagnosis of depression,” the authors write. “However, underdiagnosis and undertreatment of depression are common in cancer patients.”

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